Wentworth-Douglass Hospital’s current complication rates for joint replacement surgery have been significantly reduced over the past year due, in part, to Medicare’s strong focus on quality improvement and WDH’s Joint Replacement Performance Improvement Committee’s use of quality data to improve processes.
The public report, released earlier this week by the Centers for Medicare and Medicaid (CMS), was preceded by two preliminary reports. The first Medicare report, received in Sept. 2012 for 2008-2011, indicated WDH’s readmission rates and complication rates were no different than other hospitals. The second Medicare report, received in May 2013 for 2009-2012, indicated readmissions rates continued as no different that other hospitals, however, the complication rate had increased. In addition to receiving data from CMS, the Joint Replacement team at WDH reviews quality data regularly and identified areas for improvement during this same period.
According to Richard Montmeny, PhD, Assistant Vice President of Musculoskeletal Health for the Wentworth-Douglass Health System, the Joint team’s quality data showed strong performance with some indicators suggesting an increase in complications for Medicare patients.
“Overall we were well within the norms but a subset of the data showed a higher rate of complications for Medicare patients,” Dr. Montmeny said. “Working with our surgeons and our joint replacement team, we implemented several changes over a year ago resulting in a reduction in complications. We also know Medicare’s three-year rolling data report may not reflect these improvements for a year or more.”
Orthopedic surgeon Moby Parsons, MD, chair of Wentworth-Douglass Hospital’s Joint Replacement Performance Improvement Committee, cautions that the data report does not capture the many improvements the Hospital has made since 2011.
“We have a robust, multidisciplinary Joint Replacement Committee that meets quarterly and, as part of this review, we identified the issues with the subset of Medicare cases. We have made substantial improvements that will not be reflected for more than a year in Medicare data,” Dr. Parsons said. “We have also aligned key leaders in the hospital to develop and improve the orthopedic service line and create a Joint Replacement Center for Excellence and we have received the Blue Distinction award which recognizes excellence in quality and care delivery in total joint cases.”
Dr. Parsons added, “We are continuing to monitor our results to maintain the high performance standards our community expects. We’re proud of our focus on quality and truly care about our patients.”
Wentworth-Douglass Hospital is also actively engaged with CMS on an initiative with the Innovation Center to improve joint replacement care. Dr. Parsons said, “No other hospital in NH has taken such proactive and voluntary steps.”
The Joint Replacement Center at Wentworth-Douglass Hospital has advanced the care of joint patients over the years to include pre-surgery group education classes, group rehab inpatient classes and follow-up outpatient rehabilitation. Patient satisfaction ratings are very high with an average score of 4.8 out of 5 (5=best experience).