Grant: CIHR Fellowship

More than 77,000 Canadians undergo hip or knee replacement surgery each year. Most patients need rehabilitation to help their recovery after surgery, but there is large variation in how and when rehabilitation is provided across Canada. Further, no agreed upon standard of rehabilitation care exists. The use of quality indicators is one method to assess the variations and gaps in rehabilitation care. Building on the applicant's PhD research, the proposed postdoctoral study aims to develop a set of indicators to measure and improve the quality and consistency of rehabilitation for patients undergoing joint replacement surgery. Quality indicators should be based on the best available evidence, often in the form of systematic reviews or clinical practice guidelines. Such a synthesis of the evidence is available from the candidate's doctoral research. Using internationally accepted methods, a set of indicators will be developed for hip replacement and knee replacement rehabilitation separately. Using a Delphi survey approach, an expert panel made up of clinicians, researchers and consumers will rate the proposed indicators and decide on the final sets. These new quality indicators will then be tested in one health zone in Alberta to assess their ease of use by clinicians and health care planners for monitoring quality of care after joint replacement surgery. Future research will build on this pilot data to ensure the quality indicators are acceptable and can be implemented in other Alberta health regions and across Canada. This project offers a viable, evidence-based, stakeholder-informed solution toward improving the quality of rehabilitation care after hip and knee replacement. In addition, it contributes knowledge on the development and use of quality indicators in the rehabilitation sector.