Testing Implementation of Total Joint Replacement Rehabilitation Quality Indicator Toolkits

NCT06208553 | Unknown

• 1 other identifier: SOG-21-0115)
• Study Type: interventional
• Target: 135
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this feasibility study is to test the procedures for implementing quality indicator toolkits for hip and knee replacement rehabilitation in clinical settings. The main questions it aims to answer are:

• Are the EQUIP (for patients) and QUICK (for clinicians) toolkit resources feasible (accessible, acceptable, usable) in real world clinical settings?
• Are study procedures including recruitment and retention, informed consent, clinical site tracking, audit and feedback, training and data collection feasible?
• What effect does toolkit implementation have on patient experiences, quality of care and patient-reported outcomes? Participants will be asked to provide consent at time of discharge from rehabilitation to have their clinical records audited and to complete an online questionnaire about their physical function, quality of care they received, and overall rehabilitation experience and satisfaction. Rehabilitation providers will also be asked to complete a questionnaire on their adherence to ten post-acute rehabilitation quality indicators after a 3-month baseline period and 6-month implementation phase.

Conditions

Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee

Keywords

Rehabilitation; Physical therapy; Quality indicators

Outcome Measures

Primary Outcomes (1)

• Quality indicator adherence - chart audits

  Standardized, purpose-built online audit tool to capture adherence to 10 quality indicators, measured as number of QIs met out of 10, expressed as percentage

  Continuous data collection over 9-month study (through study completion)

Secondary Outcomes (4)

• Quality indicator adherence - patient questionnaire

  Continuous data collection over 9-month study (through study completion)

• Quality indicator adherence - clinician questionnaire

  End of baseline (3 month control period) and end of study (9 months)

• Knee injury and Osteoarthritis Outcome Score (KOOS)

  Continuous data collection over 9-month study (through study completion)

• Hip disability and Osteoarthritis Outcome Score (HOOS)

  Continuous data collection over 9-month study (through study completion)

Other Outcomes (6)

• Patient rehabilitation experience questionnaire

  Continuous data collection over 9-month study (through study completion)

• Patient feasibility outcomes (patient recruitment rate, consent rate, questionnaire completion rate)

  Continuous data collection over 9-month study (through study completion)

• Clinician feasibility outcomes (clinician consent rate, training completion rate, toolkit registration rate, focus group participation rate)

  Continuous data monitoring over 9-month study (through study completion)

Interventions

QI toolkit implementation OTHER

Patients and clinicians will have access to online toolkits of resources (e.g., video, checklist, rehabilitation tracker, quick guides) reflecting quality indicators for rehabilitation care after total hip and knee replacement surgery.

Eligibility Criteria

• Age: 19 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Clinician participants
• \- Physical therapists, rehabilitation assistants, students, and other rehabilitation providers at the study clinical site who provide direct patient care after total joint replacement
• Patient participants
• Adults ages 19 and older
• Primary total hip or knee replacement for osteoarthritis
• No significant co-morbidities or peri-operative complications that markedly prolonged acute hospital stay or delayed the start of post-acute rehabilitation
• Sufficient English language skills to provide informed consent and complete questionnaires (with/without help from a family member)
• Completed their course of supervised rehabilitation at study site

You may not qualify if:

• Unwilling or unable to provide written informed consent
• Had another lower limb joint replacement in the previous 6 months
• Received some of their post-acute rehabilitation at another clinical facility other than the two study sites
• Received fewer than 3 post-acute rehabilitation visits

Sponsors & Collaborators

• University of British Columbia: lead
• The Arthritis Society, Canada: collaborator
• Centre for Aging SMART: collaborator
• Centre for Advancing Health Outcomes: collaborator

Study Sites (1)

Centre for Aging SMART

Vancouver, British Columbia, V5Z 1M9, Canada

Location

Central Study Contacts

Marie Westby, PhD

CONTACT

604-875-4111; marie.westby@ubc.ca

Mourad Guirguis, MD

CONTACT

604 875-4111; mourad.guirguis@ubc.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Masking Details: Patient and clinician outcome measures are self-reported and therefore not blinded to study phase. Chart auditors will not be blinded to study phase.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Associate Professor

Model Details: Single phase (step) of larger stepped-wedge cluster randomized trial design in which 3-month baseline period serves as pre-test after which implementation intervention is introduced (intervention phase) and then post-test data collected (similar to time series design).

Study Record Dates

• First Submitted: December 18, 2023
• First Posted: January 17, 2024
• Study Start: January 1, 2024
• Primary Completion: October 1, 2024
• Study Completion: December 1, 2024
• Last Updated: January 17, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)