Improving the Patient Experience Following Total Knee and Total Hip Arthroplasty: A Practice Development Project

J Nurs Care Qual. 2020 Apr/Jun;35(2):171-176. doi: 10.1097/NCQ.0000000000000420.

Abstract

Background: The paradigm shift that has occurred for patients with total hip (THA) and knee (TKA) arthroplasty through enhanced recovery programs underscores the need for redesigning care provision.

Local problem: In this hospital, the patient outcomes and experience anticipated from the implementation of enhanced recovery medical protocols were not fully realized.

Methods: The Practice Development in Nursing and Healthcare model guided this project.

Interventions: A nurse-led team designed a new care delivery model with patient/family-centered interventions based on the best evidence.

Results: Outcomes included an increase in discharges of postoperative day 1 or less of 154% THA and 41.8% TKA and an increase in discharge to home by 24.6% THA and 18.7% TKA. In addition, 90-day readmissions were reduced for both patient groups.

Conclusions: An interprofessional team of clinicians made sustainable improvements in the experience and outcomes for the surgical patients with THA and TKA.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / psychology*
  • Arthroplasty, Replacement, Knee / psychology*
  • Delivery of Health Care*
  • Female
  • Hospitals
  • Humans
  • Inpatients
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Patient Care Team
  • Patient Discharge / statistics & numerical data*
  • Patient Readmission / statistics & numerical data
  • Quality Improvement