Authors:

Abstract

Introduction: In recent years, more orthopaedic surgeries have been converted into day surgery and hospitalization has been minimized, giving patients, relatives and healthcare professionals in municipalities more responsibility in the aftercare. Through a process of co-production, we have identified barriers of collaboration and knowledge sharing across sectors following complex orthopaedic surgery. In the Dialogue Project, we have developed a digital communication infrastructure with patients, relatives and healthcare professionals across sectors and disciplines using text messages as a mean of communication. The aim is to develop and evaluate text messaging as communication tool between orthopaedic surgery patients and healthcare professionals across sectors.

Methods: Theories of Continuity of Care and The Consolidated Framework for Implementation Research is used as a reference for the project. Data collection techniques are semi-structured interviews (n:20) of ten patients before and after access to use text messages to communicate with healthcare professionals across sectors after discharge, and observations (22 hours) of workflows and communication between patients and healthcare professionals. Interviews have been audio recorded and transcribed. Notes from observations have been documented in an implementation record. Data has been analyzed in NVivo. Content analysis of text messages sent between the participants has been performed.

Key Findings: Preliminary findings show that 80 % of patients in the Dialogue Project used text messages after discharge. The most frequently asked questions concerned pain, wound care, prescriptions, rehabilitation and restrictions. There is a tendency for patients undergoing day surgery to only use text messaging in the first weeks after discharge, where patients undergoing complex surgery seem to have a need for continuous contact throughout their rehabilitation period. Themes from interviews with patients and relatives: texting with health care professionals gives a feeling of security and most questions can be handled through texts, meaning patients deviated from calling other healthcare facilities. All patients report satisfaction with the opportunity to communicate in text with healthcare professionals, but the majority express concerns about “wasting” the doctor’s time, which may be a barrier to use.

Conclusions: Orthopaedic surgery patients may benefit from easy text-based contact with healthcare professionals, making them feel secure and supported after discharge. The perspectives of healthcare professionals and experiences from more patients and relatives will be published later to identify implications for clinical practice and cross sectoral collaboration.