Developing a surgeon-patient communication checklist for total knee arthroplasty.

Abstract

Total knee arthroplasty (TKA) is a well-established surgical procedure with high rates of clinical success, yet up to 20% of patients are dissatisfied with their outcomes. Surgeon-patient communication is an important contributor to patient satisfaction, particularly in the area of setting or resetting postoperative expectations that are reasonable and achievable for individual patients. The goal of the present research was to develop a communication checklist for surgeons to use with their patients, to enhance communication in order better to manage postoperative expectations and increase patient satisfaction with TKA. Content analysis was used to identify a preliminary list of checklist items from audio-recorded interviews of eight patients who were between 6weeks and 6months of their recovery from TKA. Patients identified eight issues for which more information was desired. The proportion of mentions for each topic was calculated, and chi-square tests assessed the distribution and pattern of the categories mentioned across groups of patients. Certain topics were used significantly more often than others. Age and employment status, but not gender, affected which topics were mentioned more often. The final categories for the checklist included pain management, physiotherapy, medication and general outcome information. An in-depth analysis of patient experiences of recovering from TKA was the foundation of this research. The result was a checklist that creates a potential new avenue for increasing patient satisfaction by improving surgeon-patient communication. The research described here could extend to any other type of intervention in which understanding patient expectations and increasing patient satisfaction is the goal.