Journey to 4 program certification

Purpose:
In 2010, emerging best practices prompted this orthopedic practice to revise their current total hip and knee programs as well as establish a total shoulder and hip fracture program with a goal of improved patient outcomes and four disease-specific Joint Commission certifications.

Significance:
Enhancing the patient experience through standardization of cares greatly impacts outcomes and satisfaction. Our focus on the patient journey has allowed for a decrease in length of stay and complications which has impacted our institution finacally as well.

Strategy and Implementation:
This process of program development included resource allocation for a new position of total joint coordinator, current case management model redesign, and interdisciplinary team (IDT) establishment. IDT membership was inclusive of anyone touching the patient throughout the continuum of care. The team established a standardized programming approach that included developing a charter, leadership, a timeline and selecting clinical practice guidelines. Using a rapid cycle change process; data analysis, updates and problem solving are completed at monthly IDT meetings. Education, communication and follow up were identified as keys to success. To promote these key components, we developed and provided an “Orthopedic Road Show” to introduce program changes, plans for improvement, elements of performance, the process of certification, and expectations of the IDT practice. A designated location in each practice area was identified to house quarterly data.

Evaluation:
Outcomes reflect a decrease in LOS, readmission rate, Foley days, CAUTIs and in May 2012, we were the first hospital in the nation to receive Joint Commission Specialty Certifications in Total Hip, Total Knee, Total Shoulder and Fractured Hip.

Implications for Practice:
Annual literature review compares current practice to national practices. List servs are emailed daily so as to constantly have a finger on new research related to these populations. Staff education and communication is accomplished via daily huddles, weekly unit meetings and quarterly data reviews.