Design of an Early Exercise Program for Hospitalized Patients: “Let's Move”

ABSTRACT Background Hospital‐associated deconditioning (HAD) affects up to 30% of older adults during acute hospitalization, leading to functional and cognitive decline and adverse long‐term outcomes. Purpose To develop and pilot “Let's Move,” an implementation‐oriented early exercise program designed to support mobility in hospitalized patients. Methods An action‐research study was conducted at a tertiary hospital in two stages: (i) program design based on an electronic health record (EHR) needs assessment and targeted protocol review; and (ii) pilot implementation among clinically stable adults aged ≥ 18 years, hospitalized for ≥ 48 h, without physiotherapy referral. Outcomes included Hopkins Highest Level of Mobility (JH‐HLM) functional status, adherence, and safety, complemented by qualitative interviews and a focus group. Results In Stage 1, 1399 adult inpatients without rehabilitation referral were identified (median age, 65 years [IQR, 46–78]; length of stay, 3 days [IQR, 2–4]) with circulatory diseases predominating (57.18%). Among 26 participants enrolled in the pilot, 17 were evaluable for adherence, with 13 (76.5%) classified as adherent. Walking ≥ 75 m was the most frequent JH‐HLM assessment category, no adverse events or in‐hospital deaths occurred, and 25/26 participants (96.2%) achieved individualized goals. Qualitative findings supported relevance and feasibility and informed refinements, including sessions every 2 days and standardized educational materials. Discussion “Let's Move” is a structured early‐mobilization program developed through action research that integrates brief patient education with low‐intensity exercise for routine inpatient care. It provides a practical workflow to support early mobility and warrants broader evaluation to assess its effectiveness and scalability.