24-276 / Working with patients for patients; Developing patient education tools for arthroplasty and surgical pathways.

GOP Information
Organisation sharing the GOP
Related practices from PaSQ database
Shelford Group: University College London NHS Hospitals Foundation Trust


Patient empowerment
Patient involvement
Patient education
Patient involvement
GOP Description
Implementation level
Clinical settings
UCLH Trauma & Orthopaedic Unit and surgical pre-assessment service.
1.    Meet patient information needs
2.    Engage patients in their care before, during and after their arthroplasty surgery
3.    Promote self management
4.    Manage patients expectations about their surgical pathway
5.    Develop an arthroplasty education group session
6.    Develop arthroplasty and surgical information booklets
7.    Develop a patient education film
The arthroplasty information booklets and the patient education group session were specifically developed for patients on the elective hip and knee arthroplasty surgical pathways and their families.
The patient education film and “top tips” leaflet were developed to provide general information any patients having surgery at UCLH and their families.
We collected qualitative data with the following methods:
1.    Documentary sources: National and international web search for booklets, patient education sessions, and information films on arthroplasty and surgical pathways
2.    Visit and contact UK hospitals that had implemented arthroplasty enhance recovery pathways
3.    1:1 interviews with patients that had experience of the UCLH arthroplasty pathways
4.    1:1 interviews with patients about to go on an arthroplasty surgical pathway
5.    Staff feedback on current patient information and suggestions on future developments.
6.    Engage local musculoskeletal patient groups ARMA (arthritis and musculoskeletal alliance) to gain additional perspectives on patient experience and recommendations on education tool development.
7.    Engage UCLH patient governors for their input on the arthroplasty patient education, session, information booklets and education film.During the period of developing the education tools we:
1.    Engaged all stakeholders
2.    Collaborated with the UCLH patient information department
3.    Collaborated with the UCLH communication service
4.    Presented the education tools to local and divisional clinical governance groups
Timeframe implementation
The project in its entirety took 18 months with different completion dates. This included a scoping period of three months. The patient education film took 9 months to film, edit and release. The leaflets and patient education group took approximately 2 months to finalise following the scoping period.
Implementation tools available
The GOP was co-ordinated by two part-time clinical project leads (0.75 WTE) that were employed to implement the surgical enhance recovery pathways at UCLH. The posts were under the leadership of the Trust’s service transformation programme the Quality, Efficiency and Productivity Programme.
Tools included:
•    Stakeholders analysis
•    Project planning
•    Documentation data analysis, including written and visual
•    Observation
•    Intervi
•    Focus groups
Implementation cost
The investment for the education tools was gained through a regional award and UCLH special trustees and was approximately L15,000. The investment for the time of the two part time project leads was part of the larger enhance recovery implementation programme and funded internally. Additional resources have been minimal.
Method used to measure the results
Methods used to measure GOP results:
1.    Patient and public feedback in group settings and 1:1
2.    Staff feedback in group settings and 1:1
Results of the GOP:
1.    Arthroplasty information booklets
2.    Arthroplasty patient education session (joint school)
3.    Patient information film for patients having surgery at UCLH
4.    “Top tips” leaflet helping patients prepare for surgery
Analysis of the results
Analysis of results:
Patient and staff feedback
on developments has been positive and encouraging. Patients feel re-assured that they know what to expect.Patient feedback from the
arthroplasty education session:
“You don’t realise how daunting coming into hospital and having surgery is; sitting in the group, I saw other patients and I felt that I was not the only person going through this, and I felt re-assured. When I came in to hospital and recognised some of the patients that were in the group it gave me courage as I knew I was not alone”.
Implementation barriers
Did you find implementation barriers?
Please describe implementation barriers
There were no significant barriers to implementing the education tools.
The only barrier was coordinating people, times and locations for meetings and this was overcome with forward planning and project management.
Describe the strategies used to overcome the barriers (If needed)
The only barrier was coordinating people, times and locations for meetings and this was overcome with forward planning and project management.
Other information
Other information about the GOP that you would like to add (Link or attached document)
In 2010, we set out to identify all parts of the elective care pathway that could be developed across institutional boundaries to support better preparation and recovery of patients. The majority of enhance recovery elements need patient collaboration and it was crucial we worked with patients to develop advice and information that would help them prepare for their surgery and recovery afterwards.

The initial work started with the aim to develop the arthroplasty pathway information and patient education session (joint school) but as the work with patients and staff evolved common themes emerged. We identified that the information patients and staff found useful for a surgical admission was knowing the practical side of the process rather than the exact detail or the surgical procedure. Through this work we made the decision to develop a general information leaflet and patient education film to support patients having surgery at UCLH.