Design: single-site prospective quality improvement implementation, feasibility outcomes
Population: 156 patient participations by adults aged 60 and over on a 39-bed acute geriatrics unit, mean age 77.9
Primary outcome: feasibility — sessions delivered, participants per session, recruitment, adverse events
Effect: 37 sessions, mean 4.22 participants each, 69% of those approached participated, no safety events; therapist productivity 1.59 versus 1.31 patients/hour (about 21% higher)

Hospital-associated disability is the commonest harm of admitting an older person, and the standard answer — one-to-one physiotherapy — cannot meet demand on any ward anywhere. A single-site quality improvement project ran once-weekly acute care group-based physiotherapy on a 39-bed medical-surgical geriatrics unit for eleven months, within routine operations and with no additional staffing. Eligible patients were 60 or over, medically stable, with an active physiotherapy plan, able to transfer to a chair with human assistance.

Thirty-seven sessions were delivered with a mean of 4.22 participants each (range 3 to 6), giving 156 unique patient participations. Sixty-nine per cent of patients approached took part. Mean age at participation was 77.9 years and mean time since admission 8.6 days. No safety events occurred during or immediately after any session. Therapist productivity was higher on group days than on other days — 1.59 against 1.31 patients per hour, about 21% more.

The transferable finding is the absence of a cost. This required no extra staff, no new space beyond what a 39-bed unit already has, and produced no safety events in 156 participations in a frail acute population, which is the objection most units would raise first. Twenty-one per cent more patients seen per therapist hour, in a service where the binding constraint is therapist hours, is a meaningful operational gain.

What it does not show is patient benefit. This is feasibility: sessions delivered, participation, safety and productivity. Nobody measured whether these patients mobilised better, went home sooner, or avoided hospital-associated disability, and group therapy could in principle deliver less individually-tailored progression per patient. A unit adopting it should measure discharge mobility and length of stay while it does, because that evidence does not yet exist.

Consider a weekly group session on a geriatric ward; it needed no additional staffing here
Use the eligibility criteria as written: medically stable, active physiotherapy plan, able to transfer to a chair with assistance
Measure discharge mobility and length of stay as you implement — the benefit evidence does not exist yet
Expect roughly one in three patients approached to decline, and record why
Keep one-to-one physiotherapy for those needing individualised progression rather than replacing it wholesale

Don't overread it

A single-site feasibility project with no patient outcomes — it shows the model can be run safely, not that it reduces hospital-associated disability.

The statistics, in plain English

These are feasibility and operational numbers, not effects: 37 sessions, 156 participations and a productivity difference of 1.59 against 1.31 patients per hour, compared between days rather than randomised. Days with a group session may differ systematically from days without in ways that inflate the productivity gap. Zero safety events across 156 participations is genuinely reassuring for a common event but cannot exclude a rare one. No patient-centred outcome was measured at all.