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In the not-so-distant past, WakeMed Health and Hospital reported metrics for total knee replacement (TKR) patients at their Raleigh Campus that were not ideal. “We recognized opportunities to improve infection rates, pain management, patient satisfaction, length of stay and several other metrics,” says Mark Wood, MD, an orthopaedic surgeon with Wake Orthopaedics and Executive Medical Director of WakeMed Physician Surgical Services. A review of the Total Joint Replacement (TJR) pathway revealed an outdated, silo-ridden process.

It was clear that creating a team of action-oriented employees, leaders and physicians was necessary. “We wanted to get the key players out of their offices and departments together in one room to look at each metric and understand the barriers to efficiency and success at every level,” explains Dr. Wood. “WakeMed already had the most compassionate and caring staff and talented surgeons. Our goal was to align everyone’s efforts in a patient-and family-centered approach through a consensus-approved, consistent pathway.”

In 2013, a collaborative was created to improve the value, quality and cost of orthopaedic services. The initial focus was TKR procedures and the TJR pathway. The team collaborated with The Bone and Joint Center at Magee-Womens Hospital of UPMC with the goal of achieving the “Patient and Family Centered Care Trifecta”: improve quality outcomes, reduce cost and enhance the patient experience. Using a key component of the PFCC Methodology and Practice, a cross-functional PFCC Working Group was formed and project teams focused on overhauling pre-op testing and education, improving MRSA and MSSA screening methods, revamping antibiotic choices and delivery times, prioritizing communication, and redesigning pain management and several other pathways.

One year after implementation, the results of the team’s silo-busting efforts speak for themselves. Read More...

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