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Factors that shape the patient's hospital experience and satisfaction with lower limb arthroplasty: an exploratory thematic analysis

Authors : J V Lane, D F Hamilton, D J MacDonald, C Ellis, C R Howie

Abstract

Objective

It is generally accepted that the patients’ hospital experience can influence their overall satisfaction with the outcome of lower limb arthroplasty; however, little is known about the factors that shape the hospital experience. The aim of this study was to develop an understanding of what patients like and do not like about their hospital experience with a view to providing insight into where service improvements could have the potential to improve the patient experience and their satisfaction, and whether they would recommend the procedure.

Design A mixed methods (quan-QUAL) approach.

Setting Large regional teaching hospital.

Participants 216 patients who had completed a postoperative postal questionnaire at 12 months following total knee or total hip arthroplasty.

Outcome measures Overall satisfaction with the outcome of surgery, whether to recommend the procedure to another and the rating of patient hospital experience. Free text comments on the best and worst aspects of their hospital stay were evaluated using qualitative thematic analysis.

Results

Overall, 77% of patients were satisfied with their surgery, 79% reported a good–excellent hospital experience and 85% would recommend the surgery to another. Qualitative analysis revealed clear themes relating to communication, pain relief and the process experience. Comments on positive aspects of the hospital experience were related to feeling well informed and consulted about their care. Comments on the worst aspects of care were related to being made to wait without explanation, moved to different wards and when they felt invisible to the healthcare staff caring for them.

Conclusions

Positive patient experiences were closely linked to effective patient–health professional interactions and logistics of the hospital processes. Within arthroplasty services, the patient experience of healthcare could be enhanced by further attention to concepts of patient-centred care. Practical examples of this include more focus on developing staff–patient communication and the avoidance of ‘boarding’ procedures.

Citation: J V Lane, D F Hamilton, D J MacDonald, C Ellis, C R Howie Factors that shape the patient's hospital experience and satisfaction with lower limb arthroplasty: an exploratory thematic analysis
BMJ Open 2016;6:e010871 doi:10.1136/bmjopen-2015-010871

Received: 15 December 2015 Revised: 11 March 2016 Accepted: 8 April 2016 Published: 23 May 2016

Copyright: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

Contributors

JVL, DFH, DJM and CRH devised the study. DJM collected the data and contributed to the interpretation of the results. JVL and CE undertook the qualitative analysis. JVL and DFH undertook the quantitative analysis and wrote the first draft. CRH and CE contributed to the manuscript revision.

Funding

The database from which the data were accessed is supported by an unrestricted educational grant to the University of Edinburgh by Stryker.

Competing interests None declared.