Patient and family-centered collaborative care: an orthopaedic model

Despite both longstanding and recent interest in patient-centered care, there are few published models or methods for defining and implementing patient-centered care in the office and hospital setting through a full cycle of care from the patient's perspective. We describe patient- and family-centered collaborative care as a low-technology, systems-based solution to many current problems and suggest ways to provide safe, effective, timely, and efficient health care. We presumed such a patient- and family-centered collaborative care model would provide high quality health care. We prospectively collected data on 618 consecutive patients undergoing THA or TKA within a dedicated patient- and family-centered collaborative care program. We found a high level of patient satisfaction with an overall satisfaction score of 91.4 using the Press Ganey Survey. Infection and mortality rates were 0.3% and 0.1%, respectively. Average length of stay was 2.8 days for TKA and 2.7 days for THA with 91% of all patients being discharged directly home and 93% walking without handheld assistance at the time of discharge. The patient- and family-centered collaborative care model is not just another clinical pathway but a comprehensive systems-based approach that focuses on the full cycle of care while placing patients and their families as the top priority to provide high quality health care.