Evaluating patient recall following operative orthopaedic trauma

Furdock, Ryan; Alejo, Andrew; Fraifogl, Joanne; Hoffa, Matthew T; Vallier, Heather A.

doi:10.1016/j.injury.2023.03.018

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…37 Orthopaedic trauma patients likewise report low protocol recall, medication adherence, and physical therapy adherence following surgery. [38][39][40][41][42] The inability to pre-operatively plan and educate patients on post-operative management protocols directly impacts adherence rates in orthopaedic trauma patients. Navigation programs are suggested This article is protected by copyright.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…37 Orthopaedic trauma patients likewise report low protocol recall, medication adherence, and physical therapy adherence following surgery. [38][39][40][41][42] The inability to preoperatively plan and educate patients on postoperative management protocols directly impacts adherence rates in orthopaedic trauma patients. Navigation programs are suggested as a good opportunity to overcome this barrier, leading to reductions in readmission rates, length of stay, and improved patient satisfaction, but implementation is slow without investment by hospital administration.…”

Section: Patient Factors Impacting Adherence Following Knee Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Patient Adherence Following Knee Surgery: Evidence-Based Practices to Equip Patients for Success

Rucinski,

Njai,

Stucky

et al. 2023

J Knee Surg

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Patient adherence with postoperative wound care, activity restrictions, rehabilitation, medication, and follow-up protocols is paramount to achieving optimal outcomes following knee surgery. However, the ability to adhere to prescribed postoperative protocols is dependent on multiple factors both in and out of the patient’s control. The goals of this review article are 1) to outline key factors contributing to patient non-adherence with treatment protocols following knee surgery, and 2) synthesize current management strategies and tools for optimizing patient adherence in order to facilitate efficient and effective implementation by orthopaedic healthcare teams. Patient adherence is commonly impacted by both modifiable and non-modifiable factors, including health literacy, social determinants of health, patient fear/stigma associated with non-adherence, surgical indication (elective vs. traumatic), and distrust of physicians or the healthcare system. In addition, healthcare team factors, such as poor communication strategies or failure to follow internal protocols, and health system factors, such as prior authorization delays, staffing shortages, or complex record management systems, impact patient’s ability to be adherent. Because the majority of factors found to impact patient adherence are non-modifiable, it is paramount that healthcare teams adjust to better equip patients for success. For healthcare teams to successfully optimize patient adherence, focus should be paid to education strategies, individualized protocols that consider patient enablers and barriers to adherence, and consistent communication methodologies for both team and patient-facing communication.

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Section: Accepted Manuscriptmentioning

confidence: 99%

“…37 Orthopaedic trauma patients likewise report low protocol recall, medication adherence, and physical therapy adherence following surgery. [38][39][40][41][42] The inability to preoperatively plan and educate patients on postoperative management protocols directly impacts adherence rates in orthopaedic trauma patients. Navigation programs are suggested as a good opportunity to overcome this barrier, leading to reductions in readmission rates, length of stay, and improved patient satisfaction, but implementation is slow without investment by hospital administration.…”

Section: Patient Factors Impacting Adherence Following Knee Surgerymentioning

confidence: 99%

Patient Adherence Following Knee Surgery: Evidence-Based Practices to Equip Patients for Success

Rucinski,

Njai,

Stucky

et al. 2023

J Knee Surg

View full text Add to dashboard Cite

show abstract

“…23-25,28 Research has demonstrated vast improvements in patient satisfaction, greater self-efficacy, fewer complications, less unnecessary ED utilization, fewer readmissions, and lower rates of trauma recidivism. 23,26,28,29,122-126 Substantial economic benefit to the trauma centre, in terms of revenue enhancement, with the programme has also been realized. 101 Patients are significantly more likely to return for scheduled outpatient clinic visits, related to their initial care.…”

Section: Introductionmentioning

confidence: 99%

Optimizing recovery after trauma: overview of existing literature and practices

Vallier,

Breslin,

Tayler

et al. 2023

Bone &Amp; Joint 360

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Improving Patient Recall Following Operative Orthopaedic Trauma

Furdock,

Alejo,

Hoffa

et al. 2024

Journal of Bone and Joint Surgery

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Background: Orthopaedic trauma patients may experience poor recall regarding their injury and treatment, impairing postoperative outcomes. We sought to evaluate the impact of a standardized postoperative educational protocol on patient recall, adherence to the treatment plan, and satisfaction. Methods: Two hundred and twenty adult, English-speaking patients with surgically treated lower-extremity fractures were prospectively included. One hundred and ten patients in the educational intervention cohort met with a non-physician study member after surgery but before hospital discharge. They were given a written questionnaire evaluating knowledge of key aspects of their injury and treatment plan. For incorrectly answered questions, the study team member told the patient the correct answer (e.g., “No, you broke your tibia.”). Immediately after, the patient was verbally asked the question again (e.g., “Which bone did you break?”), repeating the process until the answer was correct. The 110 patients in the control cohort did not receive this “teach-back” protocol. During their first postoperative appointment, all 220 patients completed a follow-up questionnaire assessing recall, adherence to the treatment plan, and satisfaction. Results: The control cohort correctly answered 64% of recall-oriented questions versus 89% in the intervention cohort (p < 0.001). Eighty-two percent of control patients versus 89% patients in the intervention cohort adhered to postoperative weight-bearing restrictions (p = 0.09). Eighty-four percent of controls adhered to their deep venous thrombosis prophylaxis regimen versus 99% of the intervention cohort (p < 0.001). On a 5-point Likert scale, controls were less satisfied with their overall orthopaedic care compared with patients in the intervention cohort (mean of 4.38 ± 0.84 versus 4.54 ± 0.63 points; p = 0.02), although this difference was less than the minimal clinically relevant difference of 10% that was defined at study onset. On propensity score-weighted multivariable analysis, receipt of the postoperative educational intervention was the only modifiable factor associated with improvement in patient recall (26% improvement [95% confidence interval, 20% to 31%]; p < 0.001). Conclusions: Some orthopaedic trauma patients’ nonadherence to surgeon recommendations and dissatisfaction with care may be mitigated by postoperative education. This standardized postoperative educational protocol improves orthopaedic trauma patients’ recall, adherence to their treatment plan, and satisfaction in a manner requiring minimal time. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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Evaluating patient recall following operative orthopaedic trauma

Cited by 4 publications

References 21 publications

Patient Adherence Following Knee Surgery: Evidence-Based Practices to Equip Patients for Success

Patient Adherence Following Knee Surgery: Evidence-Based Practices to Equip Patients for Success

Optimizing recovery after trauma: overview of existing literature and practices

Improving Patient Recall Following Operative Orthopaedic Trauma

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