A Snapshot of Hip and Knee Replacement Rehabilitation Care Across Canada: A Cross-Sectional Survey Using an Online Clinician Quality Indicator Questionnaire

Purpose:To determine usability, feasibility, and reliability of an online questionnaire to assess clinicians' adherence to 10 postacute rehabilitation quality indicators (QIs) for total hip (THR) and knee replacement (TKR) and explore current rehabilitation practices across Canada. Method:Following usability testing with clinicians in BC and Quebec, we recruited rehabilitation clinicians across Canada to complete the online survey. Respondents rated adherence (past 3 months), importance, and feasibility for 10 QIs. We resent the survey 2-3 weeks later (test-retest reliability). Results:Based on usability testing, we made minor changes in wording, altered response options, and created a French language version. In total, 238 clinicians completed all or parts of the English (n = 123) and French (n = 115) questionnaires. Respondents mostly practiced in the public sector (88%) and outpatient settings (42%). On average, clinicians met ("always" or "often" response) 23.3% (SD 13.7%, 95% CI 21.1, 25.4) of THR and 25.5% (SD 15.1%, 95% CI 23.0, 27.9) of TKR indicators. There were mixed views on the importance and feasibility of the QIs. Varied rehabilitation formats, duration, and dosage were described. Conclusion:Canadian rehabilitation clinicians report low overall adherence to THR and TKR rehabilitation QIs and differing rehabilitation approaches and models of care.