Telerounding Offers High Patient Satisfaction After Total Joint Arthroplasty.
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ABSTRACT: Background
Research in surgical fields other than orthopedics has demonstrated high patient satisfaction with non-traditional telerounding modalities.Questions/purposes
We sought to determine patient satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores of patients who experienced telerounding in the post-operative period after undergoing total joint arthroplasty (TJA).Methods
Fifty consecutive TJA patients were prospectively enrolled to receive telerounding. The patients were divided into two groups based on their satisfaction with telerounding. The HCAHPS scores of the patients who received telerounding were compared with 50 control patients.Results
Overall, the telerounding cohort had a positive reaction to telerounding. Comparing patients who were highly satisfied to those who were dissatisfied with telerounding, younger patients were found to be more frequently satisfied with telerounding. Compared with patients who did not receive telerounding, patients who experienced telerounding rated the hospital higher on a 10-point scale were more likely to recommend the hospital to others, more frequently believed their physicians treated them with courtesy and respect, and more often believed their physicians always listened to them carefully.Conclusion
An overwhelming majority of our patients found telerounding using FaceTime enhanced their care while recovering post-operatively from TJA. Those patients were typically younger and had significantly higher HCAHPS scores, which potentially can enhance the physician-patient relationship.
SUBMITTER: Schwartz AM
PROVIDER: S-EPMC7646716 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundPatient satisfaction has become an important metric for total joint arthroplasty (TJA) used to reimburse hospitals. Despite ubiquitous narcotic use for post-TJA pain control, there is little understanding regarding patient factors associated with obtaining opioid refills and associations with patient satisfaction.MethodsUsing our state's mandatory opioid prescription monitoring program, we reviewed preoperative and postoperative narcotic prescriptions filled for 438 consecutive TJA patients. Subjects were divided into 3 groups based on the number of post-TJA narcotic refills obtained (0, 1, or >1), and logistic regression analysis was conducted comparing demographics, surgical factors, and satisfaction with pain control.ResultsOne hundred twenty-five patients (25.8%) did not consume preoperative opioids and received no postoperative refills. Total hip arthroplasty (THA) patients (P = .0004), subjects ≥65 years (P = .0057), and Medicare patients (P = .0058) had significantly higher rates of 0 postdischarge refills. THA recipients had 268% increased odds of not receiving a refill narcotic (adjusted odds ratio = 0.373; 95% confidence interval, 0.224- 0.622). Every 100-morphine milligram equivalent (MME) increase in presurgery use led to a 16% increase in odds of needing >1 opioid refill (adjusted odds ratio = 1.161; 95% confidence interval, 1.085-1.242). Subjects who noted higher satisfaction consumed less overall opioids when receiving a refill (436 vs 1119 MMEs, P = .021).ConclusionSubjects who received fewer narcotic prescriptions and overall MMEs demonstrated higher rates of satisfaction with early pain control. Our results are consistent with other studies in showing that increased preoperative narcotic use portends higher rates of postoperative refills. There appears to be a subset of THA patients >65 years of age who may be candidates for opioid-sparing analgesia.
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Project description:BackgroundAlthough a successful operation, almost 20% of patients are dissatisfied with total knee arthroplasty (TKA). The purpose of this retrospective cohort study was to see if a medial congruent (MC) polyethylene would offer satisfactory early outcomes and patient satisfaction after TKA.MethodsWe reviewed prospectively collected data on 327 TKAs using multiple bearings within the same implant system. Ninety-six received an MC bearing, 70 received a cruciate-retaining (CR) bearing, and 161 received a posterior-stabilized (PS) bearing. We evaluated the visual analog scale pain scores and range of motion (ROM) at 2 weeks, 6 weeks, 3 months, and 1 year; Patient-Reported Outcomes Measurement Information System (PROMIS-10) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) at 3 months and 1 year; and Forgotten Joint Score (FJS-12) at 1 year.ResultsAll groups had similar KOOS and PROMIS-10 scores. MC knees had lower visual analog scale scores than PS knees at all time points (P < .05) and a higher ROM than PS at 2 weeks (98.6 vs 93.7, P = .002). MC knees had a significantly higher FJS-12 than CR knees (71.6 vs 58.7, P = .02). More MC knees were "very satisfied" than CR (92.6% vs 81.5%, P = .04). Fewer MC knees were "not at all satisfied" than CR (1.2% vs 9.2%, P = .04). There were similar satisfaction ratings with MC and PS.ConclusionsAn MC bearing provided similar or improved early pain, ROM, KOOS, PROMIS-10, FJS-12, and patient satisfaction as compared with standard bearings in TKA.
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Project description:BackgroundThe purpose of this study is to evaluate and redefine patients at high risk for increased resource utilization and complications after total joint arthroplasty (TJA), so interventions may focus on patients standing to receive the most benefit.Material and methodsThis is a retrospective study of 787 patients undergoing primary unilateral TJA from September 1, 2020, to September 31, 2021. Patients were deemed to be at "high risk" based on criteria derived from published literature and triaged to an enhanced preoperative education program. Patients that were discharged to a skilled nursing facility, had a length of stay ≥ 2 days, returned to the emergency department, or readmitted within 30 days were classified as having a composite outcome. A univariate analysis compared patients who did and did not experience the composite outcome, and multivariate regression was performed to evaluate predictors of this endpoint.ResultsDifferences in rates of 5 of the 28 risk factors were present between patients who did and did not experience composite outcomes. After controlling for other factors, African American race, planned discharge to skilled nursing facility, mental health conditions or drug use, cardiac, and neurologic conditions were predictive of the composite outcome. Patients who were reclassified as "high risk" with 1 or more of these characteristics, experienced longer length of stay and lower rates of home discharge than the rest of the population.ConclusionThis study presents a profile of high-risk TJA patients that can be incorporated into clinical practice for risk stratification and targeted intervention.
| S-EPMC9237280 | biostudies-literature
Project description:BackgroundSkin numbness after total knee arthroplasty is a common complication. The incidence in the literature is variable from 27% to 100%. However, there is conflicting evidence about the consequences of this complication. The purpose of this study was to evaluate if postoperative numbness influenced patient satisfaction or kneeling ability.MethodsWe recruited patients who underwent a total knee arthroplasty for osteoarthritis one to 5 years before the study. Sensation was measured using a Semmes-Weinstein, 10-gram monofilament. Measurements were taken in several zones around the incision, and overall sensory status was classified as full numbness, partial numbness, and no numbness. Patients completed a questionnaire evaluating their subjective numbness, overall satisfaction, and kneeling ability. We evaluated the effect of numbness on satisfaction and function.ResultsA total of 96 patients were enrolled. Thirty-four patients were classified as no sensory deficit, 29 as partial deficit, and 33 as full deficit. There were no differences in demographics. Out of all the patients that were found to have a sensory deficit, 54.8% of them did not report any subjective numbness. Average patient-reported satisfaction scores were 8.76/10, 8.97/10, and 8.48/10 for no numbness, partial numbness, and full numbness, respectively. Eleven out of 96 patients noted an inability to kneel. There was no statistical difference for satisfaction scores or kneeling ability between the groups.ConclusionSensory deficit after total knee arthroplasty is a frequently reported complication. However, the majority of the patients do not report subjective sensory deficits. Postoperative numbness does not appear to affect patient satisfaction or kneeling ability.
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