On a busy cardiac medical-surgical unit at Tufts Medical Center, nurses were caring for patients recovering from cardiac surgery, heart failure, and acute cardiac events. Lengths of stay were short. Discharge timelines were tight. Every hour mattered.
And one thing was clear: mobility was essential.
Early and consistent ambulation – for example, walking the halls or stairs with a patient - reduces complications, shortens hospital stays, and builds patient confidence before discharge.
“They’re afraid,” said Denise Ford, MSN, RN, clinical leader on North 6, the adult step-down cardiac floor of Tufts Medical Center in Boston, and a lead for the Tufts CSI team. “They haven’t moved as much as they would like to, and it’s our job to help them gain their confidence back.”
I’ve been in nursing for many years, and you’re always saying, ‘I wish we had that.... With support from senior leadership, we were able to secure the mobility role – we had great support. But I never fully understood how to keep changes in place. Through the CSI program, I’ve learned how to translate those outcomes into data and present it to leadership, which has been incredibly valuable.
However, during high-acuity shifts filled with admissions, medication administration, procedures, and discharges, consistent ambulation was often the first thing squeezed by time.
Rather than accept that tension as inevitable, a team of direct care nurses chose to address it through the Nursing Workforce Solutions program, supported by Johnson & Johnson and powered by the American Association of Critical-Care Nurses (AACN) through its Clinical Scene Investigator (CSI) academy.
This 18-month, team-based leadership and innovation program for direct care nurses focuses on advancing nurse satisfaction, retention and healthy work environments. What emerged at Tufts was a new role, a measurable workforce intervention, and a powerful example of what happens when frontline nurses are given the structure, mentorship, and leadership training to redesign care.
Nurses see the gap – and the opportunity
On the unit, nurses were encouraging patients to walk multiple times a day. Yet there often wasn’t enough time to ensure every patient received the benefit of consistent ambulation. Nurses left their shifts feeling like they hadn’t done enough. Patients were discharged without full confidence. A gap persisted between best practice and what was practically possible.
Rather than treating mobility as a documentation metric, the Tufts team reframed it as a workforce design issue.
Through the CSI program’s structured methodology, the team defined a clear aim: improve patient mobility while reducing workload burden for bedside nurses.
Designing a mobility partner role to improve outcomes
The team created a dedicated Mobility Tech role – a clinical care technician focused exclusively on patient ambulation and mobility progression.
Felix Saltman, the mobility tech, conducts scheduled walks throughout the day, monitors ambulatory oxygen saturation, identifies patients who need additional progression, and reinforces patient education and confidence before discharge.
“Patients really enjoy talking to him – that’s what they want to do. It’s been so good for the floor,” said Stefanie Hoeg, BSN, RN, clinical leader on North 6 and a lead of the Tufts CSI team.
What changed in a nurse’s day?
Ten to fifteen minutes per walk, multiple times per day, per patient, could suddenly be reinvested in admissions, complex medication management, patient education, and clinical decision-making.
“They’re being taken care of, while you focus on getting patients out, getting patients in – those 10-15 minutes taken off your plate makes the day that much smoother,” said Courtney Callow, BSN, RN, floor nurse on North 6.
Unexpected positive outcomes
The impact extended beyond workload relief.
During mobility rounds, Saltman identifies clinical issues in real time, including two stroke events that were rapidly escalated for intervention. Because of early intervention, one of those patients was discharged home within days.
Dedicated time enabled deeper observation, and deeper observation resulted in safer care.
“We had a patient this week, and we were really trying to get him off oxygen and get him home,” Ford said. “We asked Felix to really focus on him, and by the end of the day, he was off oxygen, had walked several times, and we were just like, ‘thank you.’”
Building a case with clear outcomes
The team is currently tracking metrics including patient satisfaction, nurse satisfaction, and length of stay. While early signals point to improved care and nurse satisfaction, the team is working to quantify results and demonstrate the value of the role to leadership, with the goal of scaling.
“I’ve been in nursing for many years, and you’re always saying, ‘I wish we had that,’” said Ford. “With support from senior leadership, we were able to secure the mobility role – we had great support. But I never fully understood how to keep changes in place. Through the CSI program, I’ve learned how to translate those outcomes into data and present it to leadership, which has been incredibly valuable.”
Scaling nurse-led workforce solutions
The Nursing Workforce Solutions program includes six additional months dedicated to consultation and scaling.
At Tufts, the vision is clear: leverage positive outcomes to make the case for expanding the Mobility Tech role beyond cardiac care.
“I hope that we could get a mobility tech on every floor in the hospital, especially the high turnover units,” said Ford. “The surgical units, the ortho floor, the mother-infant unit – get mom walking with the baby!”
The long-term opportunity extends beyond mobility. The Tufts team project is a strong example of how nurses equipped with leadership and innovation skills can transform care delivery.
