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Shared Medical Appointments in Preoperative Joint Replacement

Assessing Patient and Healthcare Member Satisfaction

Powell, Robert L.; Biernacki, Pamela J.

The Journal for Healthcare Quality (JHQ): September/October 2019 - Volume 41 - Issue 5 - p 329–336
doi: 10.1097/JHQ.0000000000000205
Original Article

Background: Shared medical appointments (SMAs) have proven to be effective in improving patient access and education while augmenting productivity. In shifting from a traditional visit model, patient and interdisciplinary healthcare team (IHCT) member satisfaction is imperative. Predominantly seen in primary care, SMA use in orthopedics is limited. After identification of access and productivity concerns, the SMA was implemented as a quality improvement project in a rural clinic. The lower extremity joint replacement (LEJR) population was chosen because of multiple preoperative appointments and costs on the healthcare system.

Purpose: To assess patients' and IHCT members' satisfaction levels in using an SMA for the preparation of LEJR.

Relevance to Healthcare Quality: The SMA is an effective model offering an efficient, cost-effective methodology aligning with the Institute for Healthcare Improvement's Triple Aim.

Results: Twenty SMAs were conducted. Sixty-three patients and 14 ICHT members participated. Mean (M) satisfaction rating for SMA patients (M = 4.90, SD 0.26) was significantly higher than mean for traditional patients (M = 4.03, SD 0.39). Interdisciplinary healthcare team members' attitudes toward SMAs revealed a mean score of 4.58. Incidentally, cycle times improved as did lengths of stay.

Conclusions: Lower extremity joint replacement patients and IHCT members reported high satisfaction with SMAs.

For more information on this article, contact Robert L. Powell at

The authors declare no conflicts of interest.

© 2019 National Association for Healthcare Quality
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