Grant: Pro. Gr. - PA: Inst. of Musculoskeletal Health and Arthritis: IMHA Mandate Areas

Millions of Canadians live with hip or knee osteoarthritis and experience significant pain, mental health impacts, and mobility and productivity limitations. Integrated care pathways (CPWs) are used to offer more streamlined and standardized care for patients with a given health condition. Currently, Saskatchewan (SK) has the longest wait times in Canada for hip and knee joint replacement surgeries, prompting a renewed interest for CPW implementation for the province. Addressing the surgical backlog is a strategic priority for the SK Ministry of Health and Saskatchewan Health Authority and reintroducing a CPW for hip or knee osteoarthritis can be an important part of the solution. To date, Saskatchewan has not maintained a hip and knee pathway due to a lack of uptake despite the need to improve more appropriate care for patients. To understand successful hip and knee CPWs, we will conduct a ten-step Rapid Realist Review (RRR) with patient and stakeholder engagement. During the review process, the research team will gather and analyze literature to understand how, why, and under what circumstances hip and knee CPWs work or do not work from patient, healthcare provider, and health system perspectives. After establishing initial theories from the literature about how hip and knee CPWs work, the team and patient partners will host two virtual World Cafés (structured conversations) with stakeholders, patients, and policy makers to confirm our findings through small group conversations. After synthesizing our findings, we will present recommendations to policymakers through a forum. Project findings will help to inform policy for SK CPW development and implementation by understanding the successes and challenges to CPWs. Because CPWs have the potential to improve patient, provider, and system outcomes, understanding how to implement, improve, and replicate this intervention will be important knowledge for Saskatchewan and Canadian healthcare systems.