Health professionals’ perceptions of the allied health role in the acute setting following hip and knee joint replacement surgery: a qualitative study

Abstract

Purpose: To describe health professionals’ perceptions of the role of allied health during the acute phase following elective lower limb joint replacement surgery to inform the development of efficient allied health service models.

Methods: This was a qualitative descriptive study conducted using semi-structured focus groups and thematic analysis. Participants were 25 medical, nursing, and allied health professionals working on two orthopaedic wards in a tertiary hospital in Victoria, Australia. Focus groups elicited staff perceptions regarding the aims and roles of acute allied health intervention following hip and knee replacement, how these services are currently provided, and how these services can best be provided. This study was undertaken alongside two stepped wedge cluster randomised controlled trials during which existing weekend allied health services were to be temporarily removed with opportunity to contribute to a stakeholder-driven model of these services.

Results: The main theme that emerged was a sense of unrealised potential amongst health professionals in terms of patient outcomes following hip and knee joint replacement surgery arising from tension between perceptions of actual versus ideal allied health practice. Assessing function and planning for discharge accordingly was perceived to be a higher priority than intervening to improve functional independence.

Conclusion: Prioritising allied health intervention to low functioning and complex patients could be a more efficient use of allied health expertise in patients following lower limb replacement surgery than current practice in this setting that prioritises discharge.

Implications for Rehabilitation

• Allied health service delivery in the acute phase following hip and knee joint replacement needs to balance the needs of the health service with those of the patients.

• Prioritising allied health intervention to low functioning and complex patients could be a more efficient use of allied health expertise in this population than current practice, which is to prioritise discharge.

• There may be more scope for nurses to be involved in promoting early postoperative mobilisation following joint replacement surgery, especially in uncomplicated cases.

Keywords:

• Allied health
• joint replacement
• physiotherapy
• occupational therapy

Acknowledgements

The authors wish to acknowledge Deb Mitchell for her assistance in some of the focus groups of this study. This manuscript has been written in accordance with the Consolidated criteria for reporting qualitative research (COREQ).

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by a partnership grant between the National Health and Medical Research Council (NHMRC) and Department of Health (Victoria, Australia) (APP1060696). An Australian Postgraduate Awards Scholarship supported Romi Haas.