The HNHB LHIN’s work in orthopaedics (which refers to interventions concerning bones and joints) focuses on primary hip and knee replacement. Five hospitals in the LHIN perform more than 4,000 hip and knee replacements every year: Hamilton Health Sciences, St. Joseph’s Healthcare Hamilton, Brant Community Healthcare System and Joseph Brant Hospital.
The LHIN plays an important role in supporting hospitals to provide high quality care in a prompt and efficient manner, while preparing for the future needs of a changing population. Important considerations include:
- Surgical replacement of the hip or knee is an effective way to reduce pain, improve functioning, and enhance overall quality of life
- Patient choice and alternative conservative management options are effective mechanisms to reduce pain, improve quality of life, restore functional ability, and ensure surgical intervention is provided only when necessary
- Patients have the right to prompt access to service, reducing the amount of time waiting for assessment, diagnosis, and intervention
- Patients deserve standardized, high quality care in a manner that minimizes their risk and loss of daily functioning and independence
- As the LHIN’s older population increases in size, the demand for hip and knee replacements will also increase and hospitals and community providers must therefore work hard to ensure today’s patients receive excellent care in a timely manner while preparing for future demand
Activities and Deliverables
- The development of an Integrated Orthopaedic Capacity Plan (IOCP). This document outlines a plan of optimal resource utilization for hip and knee replacements, and identifies how accessibility and quality are monitored and measured.
- The establishment of an Orthopaedic Leadership Committee comprised of administrative and physician leaders from all LHIN hospitals performing hip and knee replacements. This enables leaders to share ideas, support regional initiatives, and collaborate to provide the best care.
- Sponsorship of the Regional Joint Assessment Program (RJAP). This program provides ‘one-stop shopping’ for patients – they receive physical assessment to determine their care options as well as education on lifestyle changes, joint maintenance, available community resources and referrals for physiotherapy and aquatic programs. Patients who require surgery are provided with a choice of orthopaedic surgeon.
- The development of standardized physician order sets, patient care pathways, and patient education material. These tools ensure the same quality of service is provided to all patients, regardless of where they receive care or from which surgeon they receive their care.
- Promoting effective data management. It is important that the health care system have an accurate understanding of how many patients are waiting for surgery, in which communities, and for how long. Accurate reporting and analysis of these figures is a key priority.
- Regular performance reviews with all participating hospitals. This gives all parties the opportunity to share ideas on how to improve service delivery while identifying any challenges in meeting this goal.
Through working with hospitals and community providers, the LHIN has demonstrated success in achieving targets for efficiency, effectiveness and safety. The LHIN continues to strive for improvement, anticipating a future marked by progress and innovation, recognizing that patients deserve the best care possible.
About Hip and Knee Replacements
Primary hip and knee replacement involves the surgical replacement of an arthritic or dysfunctional joint with an artificial device to improve functioning. Most hip and knee replacements are needed when arthritis has progressed to the point of causing severe pain and dysfunction, and when other treatments such as medication, physical therapy, or weight loss do not provide relief.
Hip and knee replacements are common surgeries which require a large team of health professionals from the time of diagnosis through to rehabilitation from surgery. These professionals need to work together to ensure surgeries are successful and have positive outcomes. The overall process can take several months and requires many resources.