Authors: Donna McNeill, RN, MSN, ONC, TNCC, CAPA; Hallie R Lucas, RN, BSN
Abstract
Practice Gap
- As Total Joint Arthroplasty procedures are shifting to same-day discharge (SDD) and non-hospital TJAs. We must optimize these patient experiences.
- The goal of this study is to retrospectively analyze patient reported outcomes measures (PROMs), satisfaction, and patient engagement in THA patients based on physical therapy utilization.
- HOOS Jr Score
- VR-12 MCS/PCS
- Patient Engagement
- Procedure Satisfaction
- Value-based care
- Tech enabled data driven
Primary Outcomes
- Immediate study outcomes:
- PROMs
- Pain Score
- Return to work plan
- Predictable cost savings
- Patient Convenience: Engagement, Compliance
- Procedure Satisfaction
- Real time provider tracking intervention
Materials and Methods
- A retrospective review was conducted on patients undergoing primary THA between January 2018 and February 2020.
- All cases at an Ambulatory Surgical Center (ASC) group, MUVE Health, were enrolled in a comprehensive patient engagement program
- Discharge Same Day
- 48 Hours in Stay Suites
- Nurse Navigator Experience
- Participants enrolled in a comprehensive patient engagement program providing:
- Virtual PT
- Education
- Communication between nurse navigator and patient
- Outcomes Collection
Baseline Variables
- No significant baseline differences in gender, age, BMI, preoperative platform engagement, or PROMS
- Standard of care for our institution is to send patients home with digital platform access for in home virtual physical therapy with outpatient therapy on a case by case basis
Results: Mental
- Patient reported procedure satisfaction was significantly higher among among patients using just Virtual PT.
- Procedure satisfaction is measured on a 0-5 scale.
- Patient reported VR-12 MCS scores were significantly higher for Virtual PT patients at the 6M timepoint and 1 year timepoint
Results: Physical
- Patient reported HOOS Jr. Scores were significantly higher at both 12W and 12M timepoints.
- Patient reported VR-12 PCS scores were significantly higher at both 12W and 6M timepoints
Discussion & Conclusion
- Results of this study add to previous literature showcasing the safety and efficacy of discharging THA patients same day with virtual physical therapy.
- This is able to be successful through a comprehensive multidisciplinary approach with high patient engagement and patient selection.
- Future studies are needed, but these results support the notion that outpatient total knee arthroplasty with reduction in need for formal outpatient physical therapy is feasible and effective.
- The success of this study supports the potential of standardizing this care model.