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McKercher JP, Slade SC, Jazayeri JA, Hodge A, Knight M, Green J, Woods J, Thwaites C, Morris ME. Patient experiences of codesigned rehabilitation interventions in hospitals: a rapid review. BMJ Open 2022; 12:e068241. [PMID: 36332956 PMCID: PMC9639115 DOI: 10.1136/bmjopen-2022-068241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Codesign strengthens partnerships between healthcare workers and patients. It also facilitates collaborations supporting the development, design and delivery of healthcare services. Prior rehabilitation reviews have focused mainly on the clinical and organisational outcomes of codesign with less focus on the lived experience of rehabilitation patients. OBJECTIVE To explore patient experiences of codesigned hospital rehabilitation interventions. DESIGN Rapid review and evidence synthesis of the literature. DATA SOURCES CINAHL, MEDLINE, Embase and Cochrane were searched from 1 January 2000 to 25 April 2022. STUDY SELECTION Studies reporting patient experiences of codesigned rehabilitation interventions in hospitals. RESULTS 4156 studies were screened, and 38 full-text studies were assessed for eligibility. Seven studies were included in the final rapid review. Five out of the seven studies involved neurological rehabilitation. All eligible studies used qualitative research methods. The main barriers to codesign were related to staffing and dedicated time allocated to face-to-face patient-therapist interactions. High-quality relationships between patients and their therapists were a facilitator of codesign. Thematic synthesis revealed that codesigned rehabilitation interventions can enable a meaningful experience for patients and facilitate tailoring of treatments to align with individual needs. Personalised rehabilitation increases patient involvement in rehabilitation planning, delivery and decision-making. It also promotes positive feelings of empowerment and hope. CONCLUSION This rapid review supports the implementation of codesigned rehabilitation interventions to improve patient experiences in hospitals. PROSPERO REGISTRATION NUMBER CRD42021264547.
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Affiliation(s)
| | - Susan C Slade
- Department of Physiotherapy, Monash University, Clayton, Victoria, Australia
| | | | - Anita Hodge
- Healthscope Limited, Melbourne, Victoria, Australia
| | - Matthew Knight
- The Victorian Rehabilitation Centre, Glen Waverley, Victoria, Australia
| | - Janet Green
- School of Nursing, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Jeffrey Woods
- ARCH, La Trobe University, Melbourne, Victoria, Australia
| | - Claire Thwaites
- ARCH, La Trobe University, Melbourne, Victoria, Australia
- The Victorian Rehabilitation Centre, Glen Waverley, Victoria, Australia
| | - Meg E Morris
- ARCH, La Trobe University, Melbourne, Victoria, Australia
- The Victorian Rehabilitation Centre, Glen Waverley, Victoria, Australia
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Brusco NK, Atkinson V, Woods J, Myles PS, Hodge A, Jones C, Lloyd D, Rovtar V, Clifford AM, Morris ME. Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability. J Patient Rep Outcomes 2022; 6:73. [PMID: 35798915 PMCID: PMC9263014 DOI: 10.1186/s41687-022-00483-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient reported outcome measures (PROMs) engage patients in co-evaluation of their health and wellbeing outcomes. This study aimed to determine the feasibility, response rate, degree of recovery and patient acceptability of a PROM survey for elective surgery. METHODS We sampled patients with a broad range of elective surgeries from four major Australian hospitals to evaluate (1) feasibility of the technology used to implement the PROMs across geographically dispersed sites, (2) response rates for automated short message service (SMS) versus email survey delivery formats, (3) the degree of recovery at one and four weeks post-surgery as measured by the Quality of Recovery 15 Item PROM (QoR-15), and (4) patient acceptability of PROMS based on survey and focus group results. Feasibility and acceptability recommendations were then co-designed with stakeholders, based on the data. RESULTS Over three months there were 5985 surveys responses from 20,052 surveys (30% response rate). Feasibility testing revealed minor and infrequent technical difficulties in automated email and SMS administration of PROMs prior to surgery. The response rate for the QoR-15 was 34.8% (n = 3108/8919) for SMS and 25.8% (n = 2877/11,133) for email. Mean QoR-15 scores were 122.1 (SD 25.2; n = 1021); 113.1 (SD 27.7; n = 1906) and 123.4 (SD 26.84; n = 1051) for pre-surgery and one and four weeks post-surgery, respectively. One week after surgery, 825 of the 1906 responses (43%) exceeded 122.6 (pre-surgery average), and at four weeks post-surgery, 676 of the 1051 responses (64%) exceeded 122.6 (pre-surgery average). The PROM survey was highly acceptable with 76% (n = 2830/3739) of patients rating 8/10 or above for acceptability. Fourteen patient driven recommendations were then co-developed. CONCLUSION Administering PROMS electronically for elective surgery hospital patients was feasible, acceptable and discriminated changes in surgical recovery over time. Patient co-design and involvement provided innovative and practical solutions to implementation and new recommendations for implementation. Trial Registration and Ethical Approval ACTRN12621000298819 (Phase I and II) and ACTRN12621000969864 (Phase III). Ethics approval has been obtained from La Trobe University (Australia) Human Research Ethics Committee (HEC20479). KEY POINTS Patient reported outcome measures (PROMs) help to engage patients in understanding their health and wellbeing outcomes. This study aimed to determine how patients feel about completing a PROM survey before and after elective surgery, and to develop a set of recommendations on how to roll out the survey, based on patient feedback. We found that implementing an electronic PROM survey before and after elective surgery was relatively easy to do and was well accepted by patients. Consumer feedback throughout the project enabled co-design of innovative and practical solutions to PROM survey administration.
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Affiliation(s)
- Natasha K Brusco
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Bundoora, VIC, Australia
- Alpha Crucis Group, Melbourne, VIC, Australia
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, VIC, Australia
| | - Victoria Atkinson
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Bundoora, VIC, Australia
- Healthscope Limited, Melbourne, VIC, Australia
| | - Jeffrey Woods
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Bundoora, VIC, Australia
- Healthscope Limited, Melbourne, VIC, Australia
| | - Paul S Myles
- Anaesthesiology and Perioperative Medicine, Central Clinical School, Alfred Hospital and Monash University, Melbourne, VIC, Australia
| | - Anita Hodge
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Bundoora, VIC, Australia
- Healthscope Limited, Melbourne, VIC, Australia
| | - Cathy Jones
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Bundoora, VIC, Australia
| | - Damien Lloyd
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Bundoora, VIC, Australia
- Healthscope Limited, Melbourne, VIC, Australia
| | | | - Amanda M Clifford
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Meg E Morris
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Bundoora, VIC, Australia.
- Victorian Rehabilitation Centre, Healthscope Limited, Glen Waverley, VIC, Australia.
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