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Person-centred care compared with standardized care for patients undergoing total hip arthroplasty--a quasi-experimental study.

Olsson LE, Karlsson J, Berg U, Kärrholm J, Hansson E - J Orthop Surg Res (2014)

Bottom Line: In a recent national report, it was found that Sweden's healthcare system often fails to anticipate and respond to patients as individuals with particular needs, values and preferences.Focusing attention on patients as people and including them as partners in healthcare decision-making can result in shorter length of stay.The present study shows that the patients should be the focus and they should be involved as partners.

View Article: PubMed Central - PubMed

ABSTRACT

Background: A common approach to decrease length of stay has been to standardize patient care, for example, by implementing clinical care pathways or creating fast-track organizations. In a recent national report, it was found that Sweden's healthcare system often fails to anticipate and respond to patients as individuals with particular needs, values and preferences. We compared a standardized care approach to one of person-centred care for patients undergoing total hip replacement surgery.

Methods: A control group (n =138) was consecutively recruited between 20th September 2010 and 1st March 2011 and an intervention group (n =128) between 12th December 2011 and 12th November 2012, both scheduled for total hip replacement. The primary outcome measures were length of stay and physical function at both discharge and 3 months later.

Results: The mean length of stay in the control group was 7 days (SD 5.0) compared to 5.3 days in the intervention group (SD 2.2). Physical functional performance, as assessed using activities of daily living, was similar at baseline for both groups. At discharge, 84% in the control group had regained activities of daily living level A vs. 72% in the intervention group. At 3 months after surgery, 88% in the control group had regained their independence vs. 92.5% in the person-centred care group.

Conclusions: Focusing attention on patients as people and including them as partners in healthcare decision-making can result in shorter length of stay. The present study shows that the patients should be the focus and they should be involved as partners.

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Study flow chart.
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Related In: Results  -  Collection

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Fig1: Study flow chart.

Mentions: The study had a controlled before and after design and was carried out in three phases. Phase 1 was collecting data and mapping the control group, phase 2 was the implementation strategy and developing the gPCC and phase 3 was implementing the gPCC. A control group (n =138) and an intervention group (n =128) were consecutively recruited, and the inclusion criteria were set as scheduled for THA, able to complete instruments and willing to participate. Exclusion criteria included cognitive impairment or reluctance to participate (Figure 1).Figure 1


Person-centred care compared with standardized care for patients undergoing total hip arthroplasty--a quasi-experimental study.

Olsson LE, Karlsson J, Berg U, Kärrholm J, Hansson E - J Orthop Surg Res (2014)

Study flow chart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4222396&req=5

Fig1: Study flow chart.
Mentions: The study had a controlled before and after design and was carried out in three phases. Phase 1 was collecting data and mapping the control group, phase 2 was the implementation strategy and developing the gPCC and phase 3 was implementing the gPCC. A control group (n =138) and an intervention group (n =128) were consecutively recruited, and the inclusion criteria were set as scheduled for THA, able to complete instruments and willing to participate. Exclusion criteria included cognitive impairment or reluctance to participate (Figure 1).Figure 1

Bottom Line: In a recent national report, it was found that Sweden's healthcare system often fails to anticipate and respond to patients as individuals with particular needs, values and preferences.Focusing attention on patients as people and including them as partners in healthcare decision-making can result in shorter length of stay.The present study shows that the patients should be the focus and they should be involved as partners.

View Article: PubMed Central - PubMed

ABSTRACT

Background: A common approach to decrease length of stay has been to standardize patient care, for example, by implementing clinical care pathways or creating fast-track organizations. In a recent national report, it was found that Sweden's healthcare system often fails to anticipate and respond to patients as individuals with particular needs, values and preferences. We compared a standardized care approach to one of person-centred care for patients undergoing total hip replacement surgery.

Methods: A control group (n =138) was consecutively recruited between 20th September 2010 and 1st March 2011 and an intervention group (n =128) between 12th December 2011 and 12th November 2012, both scheduled for total hip replacement. The primary outcome measures were length of stay and physical function at both discharge and 3 months later.

Results: The mean length of stay in the control group was 7 days (SD 5.0) compared to 5.3 days in the intervention group (SD 2.2). Physical functional performance, as assessed using activities of daily living, was similar at baseline for both groups. At discharge, 84% in the control group had regained activities of daily living level A vs. 72% in the intervention group. At 3 months after surgery, 88% in the control group had regained their independence vs. 92.5% in the person-centred care group.

Conclusions: Focusing attention on patients as people and including them as partners in healthcare decision-making can result in shorter length of stay. The present study shows that the patients should be the focus and they should be involved as partners.

Show MeSH