Improving the documentation of patient mobility post oesophagectomy and gastrectomy

Mobility is an essential factor that prevents postoperative complications. Patients of all ages are at risk of postoperative complications, from clotting to muscle wasting. Remaining sedentary after surgery can increase morbidity and mortality, leading to deterioration and even death. Alongside the importance of early mobility, it is crucial that any form of ambulation is recorded. Documentation plays a major role in communication between members of the multidisciplinary team. Accurate documentation provides information in a timely and effective manner, keeping all staff on the same page and eliminating the risk of mistakes and misconduct. This quality improvement project aims to improve the documentation of postoperative mobility in patients who have received an oesophagectomy or gastrectomy who were enrolled in an Enhanced Recovery After Surgery programme. The data from the project revealed a reduced level of mobility documentation in postoperative patients, particularly on postoperative day three and onwards. It was also made evident that mobility was being recorded by healthcare professionals only, with no patient-led, autonomous documentation. Using the Lean Six Sigma framework and several quality improvement tools, the root cause for the lack of mobility documentation was identified. Recommendations of this project include the implementation of a patient mobility diary. A mobility diary could improve documentation of mobility while simultaneously providing autonomy to the patient. Implementation of this improvement would encourage the quality, patient-centred care desired by the Irish healthcare system.