Atlas:Ethnographic study of care pathways for hip and knee replacement
Research type
Research Study
Full title
The role of hospital organisation, surgical factors, and the enhanced recovery pathway on patient outcomes and NHS costs following primary hip and knee replacement surgery: spatial and longitudinal analysis of routine data
IRAS ID
191372
Contact name
Rachael Gooberman-Hill
Contact email
Sponsor organisation
University of Bristol
Duration of Study in the UK
1 years, 10 months, 23 days
Research summary
Over 160,000 people with severe hip or knee pain caused by osteoarthritis have joint replacement surgery each year in the NHS, and this number is expected to increase. We know that there are geographical variations in the uptake of common surgical procedures including hip and knee replacement. A recent study found evidence of significant unexplained variation among hospitals in both health outcomes and resource use following hip and knee replacement, but little is known about why such variation exists, or the factors that contribute to this.
The aim of the Atlas study is to understand how, and in which ways, the enhanced recovery pathway through hip and knee replacement surgery is implemented across different hospital settings, and to find out about health professionals’ and patients’ experiences of this.
The specific objectives of the study are (i) to understand the different ways in which the enhanced recovery pathway is used in practice across four different hospital settings and (ii) to understand the organisational processes that help or hinder implementation of the enhanced recovery pathway in four settings. The sites include a teaching hospital, a district general hospital, a specialist orthopaedic hospital and an independent sector treatment centre.
A qualitative researcher will spend three intensive one-week phases of fieldwork in each hospital between October 2016 and July 2017. The researcher will “shadow” aspects of professionals’ everyday work, and will interview 15-20 professionals and 10-15 patients at each site. Eligible participants will be patients undergoing joint replacement surgery, who are aged 18+, and able to give informed consent, and staff involved in delivering care and treatment to patients undergoing joint replacement.REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
16/SW/0214
Date of REC Opinion
8 Sep 2016
REC opinion
Further Information Favourable Opinion