PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.
This PCORI-funded implementation project is making patient decision aids—shown to increase knowledge and support informed decision making—part of routine orthopedic care.
|Orthopedic conditions, such as osteoarthritis and low back pain, are leading causes of disability in the United States. Surgery is a common treatment. Each year, more than 1 million hip or knee replacements take place. However, many patients make a choice without fully understanding the trade-offs between the benefits and harms of surgery.|
What is the goal of this implementation project?
For many orthopedic health problems, patients can choose between surgery and non-surgery treatment options like medicine or physical therapy. A PCORI-funded research study found that two decision aids helped patients with hip and knee osteoarthritis learn about their treatment options and make decisions based on what’s most important to them.
This project will make the tested decision aids, and others like them, a part of routine care for patients looking at treatment for one of four orthopedic problems:
- Hip and knee osteoarthritis, which causes the cartilage in joints to wear away, resulting in painful or stiff joints
- Lumbar herniated disc, a problem with the cushion-like pads, or discs, between vertebrae in the spine, resulting in back and leg pain
- Spinal stenosis, a narrowing of space in the spine that causes back and leg pain and can make it hard to move
What will this project do?
Twelve orthopedic centers across several states are taking part in the project. The project team is first working with four of these centers to figure out the best ways to make the decision aids part of routine care. Then the project team is hosting a Learning Collaborative for all 12 centers as they work to adopt the decision aids.
At each center, two staff—a clinician and an administrator—are leading the work and promoting use of the decision aids. The project team is providing support through:
- Site visits and in-person meetings
- Discussion sessions with clinicians and staff from all sites to talk about successes and challenges in using the decision aids
- Clinician and staff peer-to-peer check-ins
The project team is also creating resources to help centers use the decision aids. The resources include:
- Sample workflows of using the decision aids and staff roles
- Training materials
- A dashboard to track decision aid use and shared decision making and to analyze data
What is the expected impact of this project?
This project will show what’s required to put patient decision aids in place for routine orthopedic care. More than 13,000 patients who are considering orthopedic surgery will use the decision aids. The project evaluation will confirm that the decision aids work as intended to support informed decision making.
More about this implementation project:
Stakeholders Involved in This Project
To document implementation:
To assess healthcare and health outcomes:
Initial PCORI-Funded Research Study
This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Evaluating Different Ways to Help Patients Make Informed Choices about Surgery for Knee or Hip Osteoarthritis