A protocol for a survey of patient perceptions about outpatient joint replacement surgery (The RAAPID survey)

Background: Total knee arthroplasty (TKA) and total hip arthroplasty (THA), are the second and third most common surgical procedures performed in Canada, accounting for more than 600,000 acute care bed days and over $1 billion CAD in healthcare spending. The demand for these procedures, both in Canada and internationally, is only expected to increase. Same-day discharge has been demonstrated to be safe and effective in properly selected patients and has the potential to greatly decrease the cost of THA and TKA, collectively referred to as total joint arthroplasty (TJA). The existing literature focuses on implementing outpatient TJA from the physician’s perspective. However, patient opinions do not always align with physician opinions. To date, only one study has explored patients’ perspectives regarding outpatient TJA; many questions remain unanswered. To effectively implement or expand outpatient joint replacement programs, detailed exploration of the patient perspective is necessary.

Methods: This study is a multicentre cross-sectional survey to primarily determine the proportion of patients who are open to outpatient TJA. Adult patients scheduled for primary TJA surgery or those who have received TJA surgery in the past year will be included in the survey. The secondary objectives of this survey are to determine patient characteristics associated with openness to outpatient TJA, describe patient concerns regarding outpatient TJA, and identify potential methods to increase patient comfort with outpatient TJA.

Discussion: Resource expenditure and clinical practice are increasingly guided by subjective patient outcomes, especially in the area of joint replacement. With the current focus on cost-efficiency in healthcare, there is increasing interest in outpatient TJA. By exploring how patients perceive outpatient TJA, this study may serve to guide the development of educational resources and programs to enhance and support outpatient TJA. Addressing concerns identified by patients in an evidence-based manner has the potential to improve patient satisfaction and outcomes in the growing trend of outpatient TJA.