Evaluation Of A Nurse Practitioner-Led Preoptimization Care Management Program’s Impact On Patient Satisfaction For Total Hip And Knee Arthroplasty

Abstract

This evaluation project aimed to assess whether the nurse practitioner-led preoptimization care management program can increase patient satisfaction by improving the quality metrics, such as same-day ambulation post-surgery, discharge to home, and compliance in preoperative education. The evaluation retroactively reviewed 46 charts of primary total knee and hip arthroplasty patients, male (38%) and female (62%), aged 43 to 84. Using Fisher’s exact test to examine the Net Promoter Scores (NPS) for six months of the PCM program, there was no significant increase in patient satisfaction scores, despite PCM patients averaging 89% compared to non-PCM patients at 83%, based on an alpha value of .05, OR = 1.86, p = .532. The results suggested that the PCM program positively affected the patients enrolled, although it was not statistically significant. The results of the Chi-square test for same-day ambulation and discharge home indicated there was a statistically significant increase based on an alpha value of .05, χ2(1) = 6.03, p = .014, and an alpha value of .05, p = .025, respectively, suggesting that the implementation of the PCM program did significantly increase same-day ambulation and discharge home compliance rates. However, the Chi-square test results for preoperative education compliance were insignificant based on an alpha value of .05, χ2(1) = 0.35, p = .555. These findings indicated that a quality-focused approach improved patient satisfaction. In addition, there was a statistically significant increase in patients meeting quality metrics measured by the facility for PCM patients versus non-PCM patients. The findings indicated that quality measures may not correlate with improving patient satisfaction, but healthcare providers should focus on individualized education and health assessment. Hospital administrators should consider re-evaluating quality measures and looking for metrics directly affecting patient satisfaction. Keywords: total joint arthroplasty, NPS, net provider score, total hip arthroplasty satisfaction, patient satisfaction post joint replacement, joint replacement education, arthroplasty, preoperative education for joint replacement, preoptimization, joint replacement, nurse navigator, patient care management, joint replacement, same-day ambulatio