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Teng LJ, Goldsmith LJ, Sawhney M, Jussaume L. Hip and Knee Replacement Patients' Experiences With an Orthopaedic Patient Navigator: A Qualitative Study. Orthop Nurs 2021; 40:292-298. [PMID: 34583375 DOI: 10.1097/nor.0000000000000789] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Hip and knee replacement surgery is common, yet more than 10% of patients who undergo total hip replacement (THR) and total knee replacement (TKR) report postsurgery dissatisfaction. Recommendations for improving patient experience after total joint replacement surgery include increasing support to patients, including having a patient navigator available to patients before and after surgery. This article reports on THR and TKR patients' experiences of using an orthopaedic patient navigator. We employed qualitative description to understand THR and TKR patients' experiences of interacting with an orthopaedic patient navigator in a community teaching hospital. Telephone interviews were conducted with 15 purposefully selected total joint replacement patients (TKR: n = 11; THR: n = 4) who had at least one contact with the navigator. Interview transcripts were analyzed using thematic analysis. Patients described receiving physical support services, emotional support services, informational support services, and care coordination services from the patient navigator. All interactions with the patient navigator were positive. Knowing the patient navigator was available for any future concerns also provided indirect benefits of reassurance, comfort, and security. Patients described these direct and indirect benefits as potentially having long-lasting and resilient positive effects. An orthopaedic patient navigator can have a positive impact on patients' THR and TKR experience and fill gaps in support identified in earlier studies. Addressing patients' complex and varied care needs is well suited to a clinical nurse specialist in the role. Investing in an orthopaedic patient navigator provides reassurance to patients that their needs are a priority and will be addressed in a timely manner.
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Affiliation(s)
- Larissa J Teng
- Larissa J. Teng, MN, RN, Patient Navigator, Orthopaedic Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Laurie J. Goldsmith, PhD, Principal, GoldQual Consulting; and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Monakshi Sawhney, PhD, NP (Adult), Researcher, Orthopaedic Surgery, North York General Hospital, North York, Ontario, Canada; and Associate Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
- Linda Jussaume, BScN, MBA, RN, Program Director, Surgical Program, North York General Hospital, North York, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Laurie J Goldsmith
- Larissa J. Teng, MN, RN, Patient Navigator, Orthopaedic Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Laurie J. Goldsmith, PhD, Principal, GoldQual Consulting; and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Monakshi Sawhney, PhD, NP (Adult), Researcher, Orthopaedic Surgery, North York General Hospital, North York, Ontario, Canada; and Associate Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
- Linda Jussaume, BScN, MBA, RN, Program Director, Surgical Program, North York General Hospital, North York, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Monakshi Sawhney
- Larissa J. Teng, MN, RN, Patient Navigator, Orthopaedic Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Laurie J. Goldsmith, PhD, Principal, GoldQual Consulting; and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Monakshi Sawhney, PhD, NP (Adult), Researcher, Orthopaedic Surgery, North York General Hospital, North York, Ontario, Canada; and Associate Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
- Linda Jussaume, BScN, MBA, RN, Program Director, Surgical Program, North York General Hospital, North York, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Linda Jussaume
- Larissa J. Teng, MN, RN, Patient Navigator, Orthopaedic Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Laurie J. Goldsmith, PhD, Principal, GoldQual Consulting; and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Monakshi Sawhney, PhD, NP (Adult), Researcher, Orthopaedic Surgery, North York General Hospital, North York, Ontario, Canada; and Associate Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
- Linda Jussaume, BScN, MBA, RN, Program Director, Surgical Program, North York General Hospital, North York, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Taylor MA, Parekh SG. Optimizing Outpatient Total Ankle Replacement from Clinic to Pain Management. Orthop Clin North Am 2018; 49:541-551. [PMID: 30224015 DOI: 10.1016/j.ocl.2018.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Outpatient total ankle arthroplasty is a potential significant source of cost savings. The ability to institute an effective outpatient total ankle program depends on appropriate patient selection, surgeon experience with total ankle replacement, addressing preoperative patient expectations, the involvement of an experienced multidisciplinary care team including experienced anesthesiologists, nurse navigators, recovery room nursing staff and physical therapists, and most importantly, such a program requires complete institutional logistical support.
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Affiliation(s)
- Michel A Taylor
- Department of Orthopaedic Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710, USA
| | - Selene G Parekh
- Department of Orthopaedic Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710, USA; Duke Fuqua School of Business, 100 Fuqua Drive, Durham, NC 27708, USA; North Carolina Orthopedic Clinic, 3609 Southwest Durham Drive, Durham, NC 27707, USA.
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