Optimizing Outcomes for Major Joint Replacement
Topic Suggestion
1. What is the decision or change you are facing or struggling with where a summary of the evidence would be helpful?
What pre-hospital, hospital, and post-hospitalization services are most effective in supporting optimum functional outcomes at 6-12 months with minimal complications for patients undergoing major joint replacement surgery?
2. Why are you struggling with this issue?
As we enter an era of bundled payments, optimizing outcomes for major joint replacement surgery will become important to all hospital systems. Yet it may not be clear to healthcare systems which care pathways, management strategies and services should be aligned to achieve ideal clinical outcomes and ideal functional outcomes for patients at a time when systems will have to achieve these outcomes within a fixed reimbursement.
This question encompasses a number of sub-questions to address the effectiveness at each step of the joint replacement process. For example:
- Does pre-procedure physical therapy (pre-habilitation) support improved outcomes?
- Do Enhanced Recovery After Surgery pathways lessen length of stay and complication rates for major joint replacements?
- What care bundles and pathways are most effective in reducing Surgical Site Infections and other post-procedure infections such as CAUTI or HCAP?
- What is the comparative effectiveness of functional recovery strategies such as rehabilitation hospitalization, home physical therapy, or outpatient physical therapy? What are the patient-reported outcomes for those strategies?
- What transitional care strategies reduce readmission rates?
3. What do you want to see changed? How will you know that your issue is improving or has been addressed?
Success would mean that we can utilize the effective strategies that optimize patient function and satisfaction while being fiscally responsible utilizers of healthcare system resources.
4. When do you need the evidence report?
Mon, 07/01/2019
5. What will you do with the evidence report?
I believe answers to the main questions will support Learning Health Systems in providing care bundles that best support the Triple Aim.
Supporting Document
Strategies to Optimize Outcomes for Major Joint Replacement (PDF, 3.3 MB)
(Optional) About You
What is your role or perspective?
Physician Administrator
If you are you making a suggestion on behalf of an organization, please state the name of the organization.
LHS Panel to Encourage Use of Evidence Reports
May we contact you if we have questions about your nomination?
Yes
