RT Journal Article
SR Electronic
T1 Optimizing outpatient total hip arthroplasty: perspectives of key stakeholders
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 370
OP 376
DO 10.1503/cjs.016117
VO 61
IS 6
A1 Laura Churchill
A1 Michael Pollock
A1 Yekaterina Lebedeva
A1 Nicholas Pasic
A1 Dianne Bryant
A1 James Howard
A1 Brent Lanting
A1 Debbie Laliberte Rudman
YR 2018
UL http://canjsurg.ca/content/61/6/370.abstract
AB Background: Advances in surgical techniques combined with multimodal analgesia and early rehabilitation have potentiated early mobilization in patients undergoing total hip arthroplasty (THA). Given an increasing push from patients to accelerate recovery and health care budgetary limitations, there has been growing interest in the implementation of outpatient THA in selected patients. Understanding the patient and primary caregiver experience of outpatient THA is important to optimize care. We aimed to gain insight into patient and caregiver perspectives regarding the perceived advantages and disadvantages of same-day discharge to identify areas of care that can be improved.Method Using a qualitative descriptive approach, we conducted in-depth semistructured interviews with patient–primary caregiver dyads who experienced same-day discharge or standard care after primary THA with the direct anterior approach in 2016–2017. Two members of the research team coded the data independently, implementing a thematic and content analysis.Results: Twenty-eight participants (16 same-day discharge, 12 standard care) were included. Both groups experienced high levels of satisfaction with their care pathway. Concerns and challenges identified in both groups pertained to mobility, pain, self-care and caregiver support. Challenges and concerns unique to same-day discharge were identified regarding expectations for recovery, medications and their impact on mobility, the timing of postoperative education and the availability of formal care.Conclusion: Outpatient THA can be implemented with high patient and caregiver satisfaction. Preoperative education, clarification of recovery processes and expectations, and proactively addressing concerns related to caregiving are important.