“What Matters to You?”: A pilot project for implementing patient-centered care

Abstract

This project was intended to enhance the delivery of patient-centered care by asking patients what matters to them before and after total joint replacement (TJR) surgery. In Phase I, pre-operatively, patients undergoing total joint replacement (TJR) surgery were asked, “What matters to you before surgery, during your hospital stay, and in the first 3 months following surgery?” and “What matters to you moving forward after you’ve recovered from your joint replacement?” Four weeks post-operatively they were asked, “Now that that you’ve been through the surgery and first 4 weeks of recovery, can you identify new concerns that you didn’t have before?” and “What matters to you moving forward after you’ve recovered?” In Phase 2, 49 patients were asked pre-operatively, “Thinking ahead in this process…what matters to you?” Four weeks post-operatively, they were told, “Now that you’ve gained experience from going through a joint replacement, rank the categories in terms of how important it would have been to know in your pre-operative interview what you know now.” In Phase 1, 98% of patients answered the questions the same way pre- and post-operatively. The 2% who did not reported greater than expected surgical pain. In Phase 2, patients ranked the 3 most important categories pre- and post-operatively surgical results, quality of life, and reduction in pain. The WMTY project may increase patients’ engagement in their care, show providers how to better understand what matters to their patients, and help surgeons to define outcomes more broadly.