Abstract
IMPORTANCE: An improved understanding of the organizational influences on adult in-hospital mobility is essential to develop and sustain interventions to prevent functional decline. OBJECTIVE: The objective was to map contemporary evidence about organizational barriers and enablers of adult patient mobility in general acute hospital units, the participants reporting these barriers and enablers, and how mobility was defined. DATA SOURCES: A systematic search was conducted in Embase, Emcare, EBSCO Cumulative Index to Nursing and Allied Health Literature Complete, Cochrane Library, Joanna Briggs Institute, MEDLINE, ProQuest (Health Research Premium Collection), PsycINFO, Scopus and Web of Science for studies published in English from January 2013 to October 2024 inclusive. STUDY SELECTION: Based on eligibility criteria, 2 reviewers independently screened title/abstracts and full texts. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted study characteristics and mobility definitions. Organizational barriers and enablers of mobility were mapped to the Consolidated Framework for Implementation Research 2.0 outer (community and jurisdiction) and inner setting (hospital) domains. MAIN OUTCOMES: Fifty-one studies were included (45 primary studies and 6 reviews). Fourteen studies reported organizational barriers and enablers of mobility in the outer setting. All 51 studies reported inner setting mobility barriers and enablers, mostly related to infrastructure, culture, and available resources. Most participants were patients or health professionals providing direct patient care. Few studies defined mobility, and definitions were inconsistent. CONCLUSIONS AND RELEVANCE: Studies reported many organizational barriers and enablers of mobility at the hospital level, with far fewer reported at the community and jurisdiction level. Few studies reported the perspectives of health service leadership, and investigating their perspective may provide greater insights to address these barriers. Consistent definitions of mobility could enable progress in research and practice.Greater insights into community and jurisdictional barriers and enablers of mobility from the perspective of health care leaders are required to address organizational barriers.