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    JHHLM FAQs and Scale

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    Anushka Raipure
    This document provides background information and frequently asked questions about the Johns Hopkins Highest Level of Mobility (JH-HLM) Scale. The JH-HLM scale was developed to standardize the assessment and documentation of patient mobility during hospitalization. It is intended to record the highest level of mobility a patient achieves, not their capabilities. Mobility should be documented twice daily based on observation. The scale aims to promote early activity and mobility in hospitalized patients through goal setting and performance measurement in quality improvement projects.

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    JHHLM FAQs and Scale

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    Anushka Raipure
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    This document provides background information and frequently asked questions about the Johns Hopkins Highest Level of Mobility (JH-HLM) Scale. The JH-HLM scale was developed to standardize the assessment and documentation of patient mobility during hospitalization. It is intended to record the highest level of mobility a patient achieves, not their capabilities. Mobility should be documented twice daily based on observation. The scale aims to promote early activity and mobility in hospitalized patients through goal setting and performance measurement in quality improvement projects.

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    JHHLM-FAQs-and-Scale

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    This document provides background information and frequently asked questions about the Johns Hopkins Highest Level of Mobility (JH-HLM) Scale. The JH-HLM scale was developed to standardize the assessment and documentation of patient mobility during hospitalization. It is intended to record the highest level of mobility a patient achieves, not their capabilities. Mobility should be documented twice daily based on observation. The scale aims to promote early activity and mobility in hospitalized patients through goal setting and performance measurement in quality improvement projects.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    51 views2 pages

    JHHLM FAQs and Scale

    Uploaded by

    Anushka Raipure
    This document provides background information and frequently asked questions about the Johns Hopkins Highest Level of Mobility (JH-HLM) Scale. The JH-HLM scale was developed to standardize the assessment and documentation of patient mobility during hospitalization. It is intended to record the highest level of mobility a patient achieves, not their capabilities. Mobility should be documented twice daily based on observation. The scale aims to promote early activity and mobility in hospitalized patients through goal setting and performance measurement in quality improvement projects.

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    Johns Hopkins Highest Level of Mobility (JH-HLM) Scale

    Frequently Asked Questions


    Q: STANDING - IS THIS ACHIEVED WHEN THEY STAND WITH A STANDING TABLE FOR MORE THAN A
    MINUTE? OR ONLY IF THEY STAND UNASSISTED FOR >1 MINUTE?
    A: Standing with a standing table for >1 minute would be considered dependent and scored as a "2."

    Q: TRANSFER TO CHAIR, IS THIS ACTIVE OR PASSIVE (FOR EXAMPLE, WITH LIFTING OR WHEN USING THE
    MOBILIZER CHAIR?
    A: Dependent transfers to the chair (e.g. use of hydraulic lift) are scored as “2.”

    Q: DOES IT MATTER HOW MUCH ASSISTANCE THE PATIENT NEEDS TO ACHIEVE AN ITEM?
    A: Level of assistance does not affect scoring, EXCEPT in the case of a dependent transfer to the chair. (See question
    2 response.)

    Q: SITTING AT THE EDGE OF THE BED, DOES IT MATTER HOW LONG THEY SIT? AND IF THEY ARE SITTING
    IN BETWEEN BLOCKS?
    A: Duration and use of support devices do not affect the score for sitting edge of bed.

    Q: FOR 'BED ACTIVITY' DOES THE PASSIVE CYCLING COUNT OR ONLY WHEN THEY CYCLE ACTIVELY?
    A: Passive cycling is considered to be “bed activity,” and would score as a “2.”

    Q: FOR WALKING 10+ STEPS, DOES MARCHING ON THE SPOT COUNT OR DOES IT NEED TO BE ACTUAL
    STEPS AWAY FROM THE BED?
    A: Marching on the spot does not count towards walking. This patient would be scored as a “5” (standing >1 min).
    Q: HOW SHOULD A PATIENT BE SCORED IF THEY REQUIRE A DEPENDENT LIFT (I.E. MECHANICAL LIFT OR
    ≥ 3 PEOPLE) TO TRANSFER TO A CHAIR?
    A: Score as “2” and not as “4”

    Q: FOR STANDING >60 SECONDS, DOES THIS DURATION NEED TO BE 60 CONSECUTIVE SECONDS… OR
    IF THEY STAND TWICE, EACH FOR 35 SECONDS, DOES THIS HAVE THEM MEET THIS HLM LEVEL?
    A: Score based on cumulative performance during a session of care. A session consists of the patient performing
    mobility intervention without interruption of care, but can include rest breaks.

    Q: FOR WALKING, IS THE DISTANCE THE FURTHEST DISTANCE WALKED WITHOUT A SEATED REST BREAK,
    OR IS IT CUMULATIVE DISTANCE WALKED DURING A PT SESSION?
    A: Score based on cumulative performance during a session of care. A session consists of the patient performing
    mobility intervention without interruption of care, but can include rest breaks.

    This document, created by Johns Hopkins Activity and Mobility Promotion, is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0
    International License. To view a summary of license, please access http://creativecommons.org/licenses/by-nc-nd/4.0/
    Johns Hopkins Highest Level of Mobility (JH-HLM) Scale
    Background - A decline in functional status is common during acute care hospitalization. This decline can be mitigated
    through hospital-based early activity and mobility programs. An important component of such programs is the
    systematic measurement of patient mobility. We developed the Johns Hopkins Highest Level of Mobility (JH-HLM)
    scale to serve as a regular assessment of patient mobility.

    JOHNS HOPKINS: HIGHEST LEVEL OF MOBILITY (JH-HLM) SCALE

    The JH-HLM scale was developed based on input from multiple disciplines (nursing, physical and occupational
    therapists, physicians, etc.) for the following uses:

    § To record the mobility that a hospitalized patient actually does, not what they are capable of doing.
    Documentation is based on observation and should reflect the highest level of mobility the patient performed
    since the last documentation. We recommend JH-HLM documentation twice daily, during waking hours, on
    all patients.
    § To standardize the description of patient mobility across multi-disciplinary providers (i.e. physicians, nurses,
    rehabilitation therapists, support staff).
    § To set individual patient mobility goals during hospitalization (e.g. move up 1 step on the scale tomorrow).
    § A performance measure for quality improvement projects aimed at promoting patient mobility.

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