What patients, clinicians and health service managers describe as a satisfactory outcome at six to 12 months following ankle fracture: a qualitative study.

Abstract

Purpose: To identify what constitutes a satisfactory outcome following ankle fracture from the perspectives of people with ankle fracture, clinicians and health service managers.

Methods: Semi-structured interviews were conducted with adults with lived experience of ankle fracture, clinicians experienced in ankle fracture treatment and managers of hospitals providing care for people with ankle fracture.

Results: Patients (n = 12), clinicians (n = 12) and managers (n = 8) were interviewed. We identified two themes. A satisfactory outcome at six to 12 months following ankle fracture is: (1) a collaborative construct determined by patients and clinicians; and (2) influenced by the patient's experience of care. The first theme was elaborated through three subthemes which explained how patients and clinicians collaborate to determine a satisfactory outcome: (1) establishing indicators; (2) consideration of contextual factors; and (3) revision throughout the patient recovery journey. Managers considered re-referrals and patient feedback reflecting patient outcome and experience of care.

Conclusion: A satisfactory outcome is determined collaboratively by patients and clinicians and monitored by organisational indicators. During this process patients preference outcomes of activity/participation and clinicians preference outcomes of body structure/function. Clinicians play an important role in determining a satisfactory outcome through consideration of patient preferences and providing a positive experience of care.