Terry L Graul1. 1. Southwest Center for Neurological Surgeons, Mesa, Arizona, USA.
Abstract
PURPOSE: The purpose of this review was to define and describe 2 years of adverse outcome variances for elective primary or revision of major total joint replacement in terms of baseline benchmark data. DESIGN: Descriptive variance. METHODS: Retrospective review of patients with greater than 4 days in acute care after total joint replacement, patients with unexpected comorbidities that required medical subspecialist management, patients who were transferred to a higher level of care, and patients who did not survive postoperatively. FINDINGS: This review indicates that patients treated on a higher volume dedicated orthopaedic unit experience fewer adverse outcomes and shorter length of stay than patients treated on a general surgical unit. CONCLUSIONS: Patients who are treated on a dedicated orthopaedic unit experience significantly fewer adverse outcomes or outcome variations. Costs can be effectively managed, and optimal clinical patient outcomes can be achieved with few complications. Treatment strategies can be used as a template for enhanced care processes for this population.
PURPOSE: The purpose of this review was to define and describe 2 years of adverse outcome variances for elective primary or revision of major total joint replacement in terms of baseline benchmark data. DESIGN: Descriptive variance. METHODS: Retrospective review of patients with greater than 4 days in acute care after total joint replacement, patients with unexpected comorbidities that required medical subspecialist management, patients who were transferred to a higher level of care, and patients who did not survive postoperatively. FINDINGS: This review indicates that patients treated on a higher volume dedicated orthopaedic unit experience fewer adverse outcomes and shorter length of stay than patients treated on a general surgical unit. CONCLUSIONS:Patients who are treated on a dedicated orthopaedic unit experience significantly fewer adverse outcomes or outcome variations. Costs can be effectively managed, and optimal clinical patient outcomes can be achieved with few complications. Treatment strategies can be used as a template for enhanced care processes for this population.