Protocol-Based Arthroplasty: Less Is More

Orthopedics. 2015 Oct;38(10):631-8. doi: 10.3928/01477447-20151002-06.

Abstract

As a result of reading this article, physicians should be able to: 1. State an argument for, and background information on, patient-centered arthroplasty protocols. 2. Describe specific recommendations for designing a simplified arthroplasty care pathway that is reproducible in other institutions. 3. Discuss cost-effectiveness research on the latest value-delivering protocols. 4. Recognize areas of continued research and opportunities for future improvement in protocol development. Total joint arthroplasty is a successful orthopedic procedure that is performed in high volume in the United States and internationally. As economic pressures continue to mount in the US health care system, it will become increasingly important to minimize cost and improve quality and value. At the authors' institution, a protocol-based arthroplasty model is used, in many ways based on simplification of the patient care pathway. The largely evidence-based protocol has its foundation in eliminating unnecessary dogmatic practices, enhancing the patient experience, and achieving cost-effectiveness. The authors believe that a model like this can be applied to joint arthroplasty practices across the country in the future to maximize the value delivered to patients.

Publication types

  • Review

MeSH terms

  • Anesthesia
  • Antibiotic Prophylaxis
  • Arthroplasty, Replacement / economics
  • Arthroplasty, Replacement / methods*
  • Arthroplasty, Replacement / nursing
  • Arthroplasty, Replacement / rehabilitation
  • Blood Loss, Surgical
  • Blood Transfusion
  • Clinical Protocols*
  • Cost-Benefit Analysis
  • Evidence-Based Medicine
  • Humans
  • Pain Management
  • Physical Therapy Modalities
  • Rehabilitation
  • Surgical Wound Infection / prevention & control
  • United States
  • Urinary Catheters
  • Venous Thromboembolism / prevention & control