Assessing the acceptability of a short-stay model of care after arthroplasty to improve implementation: consumer perspectives

Assessing the acceptability of a short-stay model of care after arthroplasty to improve implementation: consumer perspectives

Cassie McDonald^1,2,3, Camille Paynter^2,3, Jill Francis^2,4, Daevyd Rodda^5,6,7,8,9, David Story<sup>3

1</sup>Allied Health, Alfred Health, Melbourne, Victoria, AUSTRALIA
²Melbourne School of Health Sciences, University of Melbourne, Parkville, Victoria, AUSTRALIA
³Department of Critical Care, University of Melbourne, Parkville, Victoria, AUSTRALIA
⁴Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Ontario, CANADA
⁵Vermont Private Hospital, Vermont South, Victoria, AUSTRALIA
⁶Cabrini Private Hospital, Malvern, Victoria, AUSTRALIA
⁷Sunshine Coast University Private Hospital, Birtinya, Queensland, AUSTRALIA
⁸Buderim Private Hospital, Buderim, Queensland, AUSTRALIA
⁹University of Sunshine Coast, Sippy Downs, Queensland, AUSTRALIA

Abstract

Introduction
Short-stay models of care after arthroplasty are being piloted in Australia based on evidence they are safe and effective. Whether short-stay care pathways after arthroplasty were acceptable to consumers was unknown: acceptability is essential to successful implementation. The study aim was to assess the acceptability of a short-stay care pathway after arthroplasty from consumer perspectives.

Methods
A theory-informed qualitative study was conducted at a single, private site from July–October 2021 (Ethics approval: 2021‐22186‐20081‐4). The Theoretical Framework of Acceptability informed the interview guide. Participants were consumers (n=15) who had recently undergone total hip or knee arthroplasty via a short-stay care pathway. Data were collected via individual semi-structured interviews and analysed using the Framework Method.

Results
Overall, a short stay in hospital arthroplasty was acceptable. Thematic findings suggested that key drivers of acceptability were: care pathway flexibility which enabled tailoring to individual needs, positive clinical outcomes, skilled and caring clinical teams (including allied health), detailed preoperative information sessions and a ‘no gap’ financial arrangement. Consumers’ prior beliefs and expectations about recovering at home also informed how accepting they were of early discharge. Acceptability was limited by feeling anxious prior to surgery, timeliness of clinical assessments at home and effort required to manage care needs during transition home.

Conclusions
Findings can inform refinement of short-stay models of care after arthroplasty. To enhance acceptability, multidisciplinary teams could consider: screening pre-operative anxiety, screening consumer beliefs about early discharge, and reviewing timing of home-based clinical assessments. Enhancing acceptability will support adoption and scaling.

Biography

Dr Cassie McDonald is passionate about improving the health literacy responsiveness of health services, improving the health outcomes of older adults transitioning home from hospital and falls prevention. She joined Alfred Health as the Allied Health Research & Knowledge Translation Lead after completing her PhD at The University of Melbourne in 2022. In her current role, Dr McDonald leads her post-doctoral research and facilitates initiatives that build research capacity and capability within allied health. She loves working collaboratively with interdisciplinary teams. She has been awarded $2.325million in CI funding to date.