P Weber1, A C Paulus2, D Hallmen2, A Steinbrück2, F Schmidutz2, V Jansson2. 1. Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland. Patrick.Weber@med.uni-muenchen.de. 2. Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
Abstract
BACKGROUND: Certification according to EndoCert in the field of arthroplasty in Germany aims at standardization of treatment and with this optimization of its quality. However, huge capital investment and efforts are necessary. There are currently more than 400 certified centres in Germany. Our Department of Orthopaedics at a German medical school was certified in the pilot phase. The aim of this study was to analyse whether there was a difference in the quality in the year after the certification. A second aim was to analyse whether the defined quality criteria are adequate for a university hospital. MATERIALS AND METHODS: The quality criteria as defined by EndoCert were analysed in the year before (2011) and after certification (2012). The observed complications were noted for 1 year postoperatively. The clinical outcome was analysed with Western Ontario and McMaster University Osteoarthritis Index Score (WOMAC) 1 year postoperatively. RESULTS: There was no difference concerning the criteria analysed, including the clinical outcome in the year before and that after certification. In both years, nearly all criteria could be reached except the operation time and the infection rate in hip and knee revision surgery. CONCLUSION: Certification did not lead to a measurable change of the quality of care. Nearly all criteria, except the infection rate in revision arthroplasty (required: less than 3% at 1 year postop.) and the operation duration could be fulfilled. This rate as well as the operation duration should be revised. Certification according to EndoCert is an important tool to prove quality care, however big efforts and capital are needed. The criteria should be constantly revised and reduced, as these resources should not be missed in patient care.
BACKGROUND: Certification according to EndoCert in the field of arthroplasty in Germany aims at standardization of treatment and with this optimization of its quality. However, huge capital investment and efforts are necessary. There are currently more than 400 certified centres in Germany. Our Department of Orthopaedics at a German medical school was certified in the pilot phase. The aim of this study was to analyse whether there was a difference in the quality in the year after the certification. A second aim was to analyse whether the defined quality criteria are adequate for a university hospital. MATERIALS AND METHODS: The quality criteria as defined by EndoCert were analysed in the year before (2011) and after certification (2012). The observed complications were noted for 1 year postoperatively. The clinical outcome was analysed with Western Ontario and McMaster University Osteoarthritis Index Score (WOMAC) 1 year postoperatively. RESULTS: There was no difference concerning the criteria analysed, including the clinical outcome in the year before and that after certification. In both years, nearly all criteria could be reached except the operation time and the infection rate in hip and knee revision surgery. CONCLUSION: Certification did not lead to a measurable change of the quality of care. Nearly all criteria, except the infection rate in revision arthroplasty (required: less than 3% at 1 year postop.) and the operation duration could be fulfilled. This rate as well as the operation duration should be revised. Certification according to EndoCert is an important tool to prove quality care, however big efforts and capital are needed. The criteria should be constantly revised and reduced, as these resources should not be missed in patient care.
Entities:
Keywords:
Arthroplasty; Clinical pathways; Outcomes assessment; Total hip replacement; Total knee replacement
Authors: Markus Weber; Michael Worlicek; Florian Voellner; Michael Woerner; Achim Benditz; Daniela Weber; Joachim Grifka; Tobias Renkawitz Journal: PLoS One Date: 2018-06-01 Impact factor: 3.240