Implementation of Perioperative Music Using the Consolidated Framework for Implementation Research.

Area of Science:

• Health Services Research
• Implementation Science
• Integrative Health

Background:

• Complementary integrative health therapies can reduce perioperative pain, analgesic use, and anxiety, while improving patient satisfaction.
• Significant implementation lags hinder the adoption of these therapies.
• The Consolidated Framework for Implementation Research (CFIR) offers a structured approach to address these translational challenges.

Purpose of the Study:

• To evaluate the feasibility and penetration of a CFIR-guided implementation of perioperative music therapy.
• To assess patient and provider factors influencing the adoption of music therapy in a Veterans Affairs (VA) hospital setting.
• To examine the impact of music therapy on postoperative recovery time.

Main Methods:

• A systematic review of nonpharmacological treatments was conducted.
• Surveys assessed external context and organizational readiness for change among 97 providers at 11 VA hospitals.
• Patient willingness to receive music therapy was assessed, and its association with opioid use risk factors was analyzed.
• A protocol for perioperative music player use was implemented and evaluated over 6 months in joint replacement patients.

Main Results:

• Evidence for perioperative music and acupuncture was strong; other therapies showed weaker evidence.
• Providers generally had positive readiness for change scores, with higher scores at the Durham VA.
• Approximately 68% of surveyed veterans were willing to receive music therapy, particularly younger patients with higher preoperative pain.
• Music therapy penetration was modest (39/81 recipients), potentially due to device availability issues.
• Postoperative recovery time did not significantly change.

Conclusions:

• CFIR-guided implementation of perioperative music therapy is feasible in a tertiary VA hospital.
• The intervention demonstrated moderate penetration in a high-risk patient subset.
• Strong evidence, provider readiness, patient acceptability, and a protocolized approach supported music therapy implementation.
• Further research is needed to identify effective knowledge-translation frameworks for similar interventions.