scholarly journals Patient experience with early discharge after total knee arthroplasty: a focus group study

2017 ◽  
Vol 32 (2) ◽  
pp. 833-842 ◽  
Author(s):  
Lise Husby Høvik ◽  
Bjørg Aglen ◽  
Vigdis Schnell Husby
Keyword(s):  
Total Knee Arthroplasty ◽  
Focus Group ◽  
Patient Experience ◽  
Knee Arthroplasty ◽  
Early Discharge ◽  
Focus Group Study ◽  
Total Knee

scholarly journals Exploring Race Differences in Satisfaction with Rehabilitation Following Total Knee Arthroplasty: a Qualitative Study

2021 ◽  
Author(s):  
Allyn M Bove ◽  
Erin R Dong ◽  
Leslie R M Hausmann ◽  
Sara R Piva ◽  
Jennifer S Brach ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Physical Therapy ◽  
Focus Group ◽  
Knee Arthroplasty ◽  
Physical Therapists ◽  
Race Differences ◽  
Theory Approach ◽  
Focus Group Study ◽  
Black And White ◽  
Total Knee

Abstract Background The purpose of this qualitative focus group study was to explore race differences in the rehabilitation experience and satisfaction with rehabilitation following total knee arthroplasty (TKA). Methods We conducted a series of qualitative focus group discussions with groups of Non-Hispanic White and Non-Hispanic Black older adults who recently underwent TKA. We used grounded theory approach, which asks the researcher to develop theory from the data that are collected. Participants discussed barriers and facilitators to accessing rehabilitation after surgery, opinions regarding their physical therapists, the amount of post-operative physical therapy received, and overall satisfaction with the post-operative rehabilitation process. Results Thirty-six individuals participated in focus groups. Three major themes emerged: (1) Participants reported overall positive views of their post-TKA rehabilitation experience. They particularly enjoyed one-on-one care, the ability to participate in “prehabilitation”, and often mentioned specific interventions they felt were most helpful in their recovery. (2) Despite this, substantial barriers to accessing physical therapy exist. These include suboptimal pain management, copayments and other out-of-pocket costs, and transportation to visits. (3) There were minor differences in the rehabilitation experiences between Black and White participants. Black participants reported longer paths toward surgery and occasional difficulty interacting with rehabilitation providers. Conclusions Individuals undergoing TKA can largely expect positive rehabilitation experiences post-operatively. However, some barriers to post-operative physical therapy exist and may differ between Black and White patients. Physical therapists should increase their awareness of these barriers and work to minimize them whenever possible.

scholarly journals Patients' experiences and satisfaction at one year following primary total knee arthroplasty: A focus‐group discussion

2020 ◽  
Vol 18 (4) ◽  
pp. 434-449
Author(s):  
Bodor Bin Sheeha ◽  
Anita Williams ◽  
David Sands Johnson ◽  
Malcolm Granat ◽  
Richard Jones
Keyword(s):  
Total Knee Arthroplasty ◽  
Focus Group ◽  
Focus Group Discussion ◽  
Knee Arthroplasty ◽  
Group Discussion ◽  
Primary Total Knee Arthroplasty ◽  
Total Knee ◽  
One Year ◽  
Primary Total Knee

Does Gender Influence How Patients Rate Their Patient Experience after Total Knee Arthroplasty?

2017 ◽  
Vol 30 (07) ◽  
pp. 634-638 ◽  
Author(s):  
Marcelo Siqueira ◽  
Morad Chughtai ◽  
Anton Khlopas ◽  
Chukwuweike Gwam ◽  
Jaydev Mistry ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Experience ◽  
Knee Arthroplasty ◽  
Pay For Performance ◽  
Continuous Variables ◽  
Chi Square ◽  
Men And Women ◽  
Significant Difference ◽  
Total Knee ◽  
Chi Square Analysis

AbstractThe Centers for Medicare and Medicaid Services has implemented the Value-Based Purchasing (VBP) score as a pay-for-performance reimbursement model. Patient experience, as measured by the Press Ganey (PG) survey, currently comprises 20% of total VBP score. It is therefore beneficial for the orthopaedist to become familiar with these changes to maximize profits. Currently, a paucity of data exists that elucidates which factors influence PG scores between men and women following total knee arthroplasty (TKA). Therefore, we asked: (1) which PG survey factors most influences hospital ratings among men and women patients post-TKA and (2) is there a significant difference in overall hospital ratings among men and women cohorts post-TKA? We queried the PG database for patients who received a TKA between November 2009 and January 2015, yielding 224 men (mean age 64 years, range: 39–88) and 519 women (mean age 65 years; range, 25–92). A multiple regression analysis was performed for each cohort with overall hospital satisfaction as the dependent variable to assess the influence (β-weight) each PG domain imparted on overall hospital rating. A chi-square analysis and t-test were performed to assess categorical and continuous variables, respectively. For men, communication with nurses (β = 0.408, p = 0.016), followed by communication about medications (β = 0.261, p = 0.032), most influenced overall hospital rating. For women, communication with nurses (β = 0.479, p < 0.001) most influenced overall hospital rating. This was followed by staff responsiveness (β = 0.201, p = 0.046), pain management (β = 0.263, p = 0.015), and communication about medications (β = − 0.152, p = 0.029). It is of great advantage for the orthopaedist to focus on the PG domains most pertinent to each patient gender post-TKA. For both genders, overall hospital rating was significantly influenced by communication with nurses and information about medication. However, staff responsiveness and pain control were of significant importance in determining overall hospital rating for women. Therefore, orthopaedists should consider focusing on these factors depending on the gender of the patient to optimize satisfaction.

scholarly journals Using patient experience in optimizing the total knee arthroplasty patient journey

2019 ◽  
Vol 6 (3) ◽  
pp. 55-65
Author(s):  
Nienke Wolterbeek ◽  
Dieuwertje J Hiemstra ◽  
Fiona A van der Hoeven ◽  
Kiem G Auw Yang
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Experience ◽  
Knee Arthroplasty ◽  
Total Knee Arthroplasty Patient ◽  
Patient Journey ◽  
Total Knee

scholarly journals Perspective of potential patients on the hospital volume-outcome relationship and the minimum volume threshold for total knee arthroplasty: a qualitative focus group and interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlotte M. Kugler ◽  
Karina K. De Santis ◽  
Tanja Rombey ◽  
Kaethe Goossen ◽  
Jessica Breuing ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Focus Group ◽  
Knee Arthroplasty ◽  
Hospital Volume ◽  
Minimum Volume ◽  
Outcome Relationship ◽  
Volume Outcome ◽  
Total Knee ◽  
Minimum Volume Threshold

Abstract Background Total knee arthroplasty (TKA) is performed to treat end-stage knee osteoarthritis. In Germany, a minimum volume threshold of 50 TKAs/hospital/year was implemented to ensure outcome quality. This study, embedded within a systematic review, aimed to investigate the perspectives of potential TKA patients on the hospital volume-outcome relationship for TKA (higher volumes associated with better outcomes). Methods A convenience sample of adults with knee problems and heterogeneous demographic characteristics participated in the study. Qualitative data were collected during a focus group prior to the systematic review (n = 5) and during telephone interviews, in which preliminary results of the systematic review were discussed (n = 16). The data were synthesised using content analysis. Results All participants (n = 21) believed that a hospital volume-outcome relationship exists for TKA while recognising that patient behaviour or the surgeon could also influence outcomes. All participants would be willing to travel longer for better outcomes. Most interviewees would choose a hospital for TKA depending on reputation, recommendations, and service quality. However, some would also choose a hospital based on the results of the systematic review that showed slightly lower mortality/revision rates at higher-volume hospitals. Half of the interviewees supported raising the minimum volume threshold even if this were to increase travel time to receive TKA. Conclusions Potential patients believe that a hospital volume-outcome relationship exists for TKA. Hospital preference is based mainly on subjective factors, although some potential patients would consider scientific evidence when making their choice. Policy makers and physicians should consider the patient perspectives when deciding on minimum volume thresholds or recommending hospitals for TKA, respectively.

scholarly journals Intrinsic Patient Factors Predictive of Inpatient Rehabilitation Facility Discharge Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.

2020 ◽  
Author(s):  
Larissa Nicole Sattler ◽  
Wayne Anthony Hing ◽  
Evelyne Rathbone ◽  
Christopher John Vertullo
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Discharge Planning ◽  
Meta Analysis ◽  
Inpatient Rehabilitation ◽  
Female Gender ◽  
Early Discharge ◽  
Discharge Destination ◽  
Patient Factors ◽  
Total Knee

Abstract Background Total Knee Arthroplasty (TKA) reduces pain and improves function in those suffering from severe osteoarthritis. A significant cost of TKA is post-acute care, however, current evidence suggests that discharge to an Inpatient Rehabilitation Facility (IRF) has inferior outcomes to home discharge, with no greater benefit in physical function. Only individual studies have investigated TKA patient characteristics predictive of discharge destination, therefore, the aim is to systematically review the literature and meta-analyse intrinsic patient factors predictive of IRF discharge. If predictive factors are known, then early discharge planning and intervention strategies could be implemented. Methods Databases PubMed, CINAHL, Embase, Cochrane, and Pedro were searched up to October 2019 for all studies investigating pre-operative intrinsic patient factors predictive of IRF discharge. For assessing the methodological quality of included studies, the Quality In Prognosis Studies (QUIPS) tool was used. Statistical analysis and graphical reporting were conducted in R statistical software. To assess the effect of predictors of discharge destination, odds ratios with the corresponding 95%CI were extracted from the results of univariate and multivariable analyses. Results A total of 9 articles published between 2011 to 2018 with 218,151 TKA patients were included. Of the 13 intrinsic patient factors reported, 6 met the criteria for synthesised review: age, obesity, comorbidity, gender, SF-12/VR-12 survey, and smoking. Due to the heterogeneity of statistical analysis and reporting 2 variables could undergo meta-analysis, gender and smoking. Female gender increased the likelihood of IRF discharge by 78% (OR=1.78; 95%CI=1.43–2.20; I2=33.3%), however, the relationship between smoking status and discharge destination was less certain (OR=0.80; 95%CI=0.42–1.50; I2=68.5%). Conclusion In this systematic literature review and meta-analysis female gender was shown to be predictive of IRF discharge after total knee arthroplasty. There was also a trend for those of older age and increased comorbidity, as measured by the Charlson Comorbidity Index, or the severely obese to have an increased likelihood of IRF discharge. The marked heterogeneity of statistical methods and reporting in existing literature made pooled analysis challenging for intrinsic patient factors predictive of IRF discharge after TKR. Further, high quality studies of prospective design on predictive factors are warranted, to enable early discharge planning and optimise resource allocation on post-acute care following TKA.Trial Registration: This review was registered with PROSPERO (CRD42019134422)

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