Continuous improvement of patient experience in primary hip and knee arthroplasty through periodic satisfaction assessment: A quality improvement study in a private orthopedic hospital - 13/03/26

Doi : 10.1016/j.otsr.2026.104654

Martin Lavigne ^a,^b,^c,^d, Iris Vendittoli ^a, Marc-Olivier Kiss ^a,^b,^c,^d, Vincent Massé ^a,^b,^c,^d, Jean-Paul Brutus ^a, Gautier Beckers ^a, Pascal-André Vendittoli ^a,^c,^d,⁎

^a Université de Montréal, Faculté de médecine, 2900 Bd Édouard-Montpetit, Montréal, QC H3T 1J4, Canada

^b Department of Surgery, Hôpital Maisonneuve-Rosemont, 5415 Boulevard de l'Assomption, Montreal, QC H1T 2M4, Canada

^c Clinique Orthopédique Duval, 1487 Bd des Laurentides, Laval, QC H7M 2Y3, Canada

^d Personalized Arthroplasty Society, Atlanta, GA 30305, United States

^⁎ Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 13 March 2026

Abstract

Background

Patient satisfaction is a key dimension of healthcare quality and is increasingly recognized as an outcome that influences engagement, recovery, and trust. In hip and knee arthroplasty, the overall experience is shaped not only by surgical success but also by communication, symptom control, perioperative logistics, and postoperative support. This study evaluated whether structured, periodic measurement of patient satisfaction could identify modifiable aspects of care and guide targeted quality-improvement interventions in a high-volume private orthopedic hospital.

Methods

Since 2021, all patients undergoing primary hip or knee arthroplasty at a private orthopedic hospital were asked to complete an 11-item visual analogue satisfaction questionnaire at discharge, with free-text comments. Responses were analyzed annually. Between 2022 and 2024, sequential quality-improvement measures were introduced based on survey findings. Year-to-year trends in satisfaction scores and the proportion of negative comments were examined.

Results

A total of 2137 surveys were completed over the study period (response rate: 68.7%). Overall satisfaction was consistently high (≥9.7/10). Quality improvement measures included enhanced nursing follow-up, refinements in perioperative analgesia and anesthetic protocols, improvements to food services, and expanded preoperative information. Significant improvements were observed in domains targeted by interventions. The proportion of negative comments declined markedly across almost all domains. Free-text analysis highlighted the importance of clear communication, personalized support, rapid access to staff, and a sense of emotional safety.

Conclusion

Structured, periodic satisfaction assessment is a practical and effective method to identify actionable gaps in the patient experience and to support rapid-cycle improvements in arthroplasty care. Even within a high-performing environment, small, targeted adjustments informed by patient feedback led to measurable gains across multiple domains. These findings reinforce the value of integrating patient-experience data into continuous quality-improvement frameworks, particularly in settings capable of agile implementation.