Background
Thirty percent of patients aged >65 years experience hospital-acquired functional decline, which is avoidable with minimal levels of physical activity. Owing to the lack of an appropriate measure, physical activity is not currently measured by hospitals, nor documented. The aim of this study was to determine the perspectives of hospitalised older adults and clinicians on measuring physical activity in hospitals, in order to develop a physical activity ‘vital sign’ for hospital settings.

Methods
Within eight local and international health services, multidisciplinary hospital clinicians and hospitalised older adults were recruited to participate in focus groups and semi-structured interviews. Conventional content analysis was used to analyse transcripts, focussing on ‘what matters’ and ‘what is feasible’ with respect to measuring physical activity in hospital settings.

Results
Content generated from focus groups and interviews included that: physical activity is not measured in hospitals, but clinicians and patients believe it should be; nurses believe they play a key role in collecting/reporting physical activity data and that, if quick to administer, this could be integrated into their routine monitoring tasks; an indicator of patients’ level of independence should be included; and physiotherapists and occupational therapists want to use the vital sign as a goal setting tool.

Conclusions
A new physical activity vital sign will contribute significant value to understanding patient activity levels in real-world hospital settings, thereby highlighting physical activity as a critical component of care, in order to drive behaviour change, avoid hospital-acquired function decline (particularly in older adults) and improve hospitalisation outcomes.