Practice of Medicine


Improving the Patient Experience in Orthopedic Surgery

By: Georgette A. Samaritan, RN, BSN, CPHRM
Executive Summary

Improving the patient experience in orthopedic surgical practice can reduce the frequency and severity of professional liability claims. This can be accomplished through preoperative education, patient-completed outcome measures, better preoperative and postoperative pain management and a focus on minimally invasive surgical strategies.

Recommended Actions
  • Consider incorporating preoperative educational classes and videos during the informed consent process with a patient.
  • Establish thorough discharge plans with patients to consider all obstacles associated with their post-operative living arrangements and recovery.
  • Pursue a minimally invasive or less-invasive approach if it can achieve both surgeon and patient treatment goals.

Today’s orthopedic surgeons face many issues, such as dealing with information technology, pushing forward biologic solutions to orthopedic problems, increasing costs of implants and increasing demands for "peer-to-peer" reviews from insurers, and reimbursement challenges.[1] In addition, there is an ever-evolving business model that includes patient empowerment and improving the patient experience in four distinct areas of orthopedic surgical practice:

  1. Proper management of postoperative expectations by improving preoperative education
  2. Patient-completed outcomes measures
  3. Better preoperative and postoperative pain management
  4. Appropriately applied, minimally invasive surgical strategies.

A number of studies have shown that improving the patient experience will reduce the frequency and severity of professional liability claims.[2][3][4][5] MMPSI consultants suggest that orthopedic surgeons consider incorporating these evidenced-based recommendations into their practices:

  • Set outcome and patient behavioral expectations immediatelyso that both surgeons and patients know what is expected.
  • Be clear on the realistic results of the proposed surgery. For example, it's not a back pain cure.
  • Hold preoperative educational classesthat walk patients through each step of the surgical process. Also, some excellent procedure-specific patient educational programs that may be incorporated into a physician’s informed consent process are available online.
  • Create a discharge plan. Pre-surgical discussions with patients and their families need to consider all potential obstacles associated with their post-operative living arrangements.
  • Providecompassion and empathy to patients faced with the uncertainty of their medical conditions and disability.
  • Utilize a team approach. Multidisciplinary medical professionals working together throughout the entire patient treatment process can keep the patient engaged and uncover specific issues, concerns and goals, which often leads to better outcomes.
  • Treat pain effectively. A team approach involving nurses, physician assistants, residents and pain specialists — before and after surgery — and open communication with the patient at all points of care will help put patients at ease.
  • Establish postoperative pain management protocols. Postoperative pain is often the patient's greatest fear. Communicating a clear plan of action regarding aggressive pain management can calm concerns and assuage fears of surgical procedures.

Finally, if a minimally or less-invasive approach will achieve treatment goals, physicians and patients should consider it. Limiting surgical trauma and shortening hospital stays always improves the patient experience[6].

Lessons Learned
  • Thoroughly discuss preoperative and postoperative care plans with patients during the informed consent process and before they agree to surgery.
  • Consider developing educational resources as a reference to guide patients through postoperative pain management.
  • Reassure patients that clinical staff, nurses and physicians are working together to provide the best continuum of care, guide them through the process and answer any questions they may have.
Potential Damages

When it comes to orthopedic surgery, failing to improve the patient experience can cause significant professional liability issues. Miscommunication with patients or other staff can end in poor patient outcomes and increase the likelihood of litigation for negligent care. Claims brought for poor provider communication are relatively frequent and can lead to costly compensation to patients for the harm they have suffered.

[1] Laura Dyrda, The biggest challenge facing orthopedic surgeons for 2015: 11 surgeons respond; Becker’s  Orthopedic Review; Monday, 03 November 2014 15:26;

[2] John Goodman, BS, MBA,and Dianne Ward, BS, MA ,Satisfied Patients Lower Risk and Improve the Bottom Line, Patient Safety & Quality Healthcare March / April 2008,

[3] James W. Saxton, Esq, Gregory Pawlson, MD, MHP, and Maggie M. Finkelstein, Esq, How physicians can survive the perfect storm developing in healthcare today-and thrive,

[4] Carolyn M. Clancey, MD, Patient Safety and Medical Liability Reform: Putting the Patient First:

[5]Bhanu Prakash, Patient satisfaction, J Cutan Aesthet Surg. 2010 Sep-Dec; 3(3): 151–155.doi:10.4103/0974-2077.74491

[6] IBID


1. Physicians should utilize a multidisciplinary approach, working together throughout a patient’s treatment process.
2. Physicians should set high expectations for surgery results and assume patients will meet the greatest outcomes.
3. Discharge plans and expectations should be discussed with patients before surgery to consider obstacles that can impact their recovery.


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The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.