Development of a center of excellence for joint replacement.

The annual number of total hip and knee replacements roughly doubled between 1994 and 2004, and this trend is projected to continue. These surgical patients are often older and many have special postsurgical care and rehabilitation needs. However, historically they have been incorporated into the general orthopaedic patient population. The development of centers of excellence in joint replacement has become one method for meeting the special needs of this population. This article describes the journey one midwestern healthcare system has taken in establishing a consolidated, specialized joint replacement center, which has received the Joint Commission's Disease-Specific Care Certification for hip and knee replacement. Specific steps in the development of the center, implementation, evaluation and outcomes, and lessons learned are described.