Patients' satisfaction and experiences during elective primary fast-track total hip and knee arthroplasty journey: A qualitative study

Abstract

Aims and objectives: To explore how satisfied patients are with the process of treatment and care and to identify the experiences that patients perceive during elective primary fast-track total hip and knee arthroplasty journey.

Background: Greater satisfaction with care has predicted better quality of recovery, and patient experience has been positively associated with patient safety and clinical effectiveness. However, a little is still known about how patients experience their treatment and care.

Design: A qualitative interview study.

Methods: The study was conducted among 20 patients in a single joint replacement centre during 2018. Patient satisfaction was measured using a numerical rating scale. Patients' experiences were identified through qualitative semi-structured interviews which were analysed using an inductive content analysis method. The COREQ checklist was used (Supporting Information).

Results: The mean numerical rating scale score for overall satisfaction was 9.0 (SD 1.1) on a scale from 0-10. The patients' experiences were grouped under eight main categories that were derived from the qualitative data in the analysis: (a) patient selection, (b) meeting the Health Care Guarantee, (c) patient flow, (d) postdischarge care, (e) patient counselling, (f) transparency of the journey, (g) communication and (h) feedback.

Conclusions: The findings suggest that patients are highly satisfied after an elective primary fast-track total hip and knee arthroplasty. However, closer analysis of the patients' experiences reveals challenges and suggestions on how they could be solved, often involving digital technologies.

Relevance to clinical practice: As the number of total joint arthroplasties grows, patients and their families need to take ever greater responsibility, for their own care from advance preparation to rehabilitation. The findings of the study can be used to organise work, improving patient-clinical communication, fostering engagement and improving patient centredness. In addition, the results pinpoint the issues on how the patient experience could be improved.

Keywords: care pathways; hip replacement; knee replacement; patient experience; qualitative study; satisfaction with care.