An Integrated Health Care System's Approach to Development of a Process to Collect Patient Functional Outcomes on Total Joint Replacement Procedures

摘要

Health care organizations are challenged to find ways to measure not only process of care but also outcomes of care. Gundersen Health System's Orthopaedic Surgery Department in the La Crosse, Wisconsin area developed a process to collect outcomes of care for patients having hip or knee arthroplasty procedures and planned to use these data to determine impact on patients' lives. The Hip Osteoarthritis Outcomes Score and Knee Osteoarthritis Outcomes Score, adapted from the widely used Western Ontario and McMaster Universities Osteoarthritis Index, were collected preoperatively and at 1 year postoperatively. From these data, the health system determined that patients were experiencing significant improvement in 4 of 5 scales. Further recommendations include evaluating the impact of patients' age, sex, and preoperative body mass index on outcomes, as well as evaluating the impact of more patient involvement in goal setting on recovery time and functional outcomes.