ALBERTA HIP & KNEE REPLACEMENT PROJECT

Project Background

Faster Access, Patients More Satisfied in Pilot for Hip and Knee Replacement Model

The ABJHI, through its Provincial Service Design Working Group, developed a significantly improved evidence-based hip and knee replacement care model, after carefully reviewing the existing conventional approach to joint replacement care. 

Evidence gathered from medical literature and proven best practices was used to develop new standards for wait times, clinical quality, resource utilization and effectiveness.  The ABJHI’s new care model included innovative changes such as a standardized and central intake for patients, single-purpose focused facilities that provide all facets of bone and joint care under one roof, a multi-disciplinary team approach to patient care, case managers assigned to all patients, patient contracts, and designated operating rooms with consistent operating teams.

The new care model was presented to Alberta’s Ministry of Health and Wellness, which subsequently provided funding to pilot the new continuum of care for 1,200 patients.  Three new team-based central intake clinics were established in Calgary, Edmonton and Red Deer for the program, called the Alberta Hip and Knee Replacement Pilot Project. 

Currently, some 3,500 patients are participating in the ABJHI evaluation of the pilot.

The model represents a complete and detailed continuum of care that significantly improves access to and the quality and efficiency of bone and joint health service.  Interim results announced in December 2005 demonstrated that patients receiving care in the new model had significantly faster access to consults and surgery and were more satisfied with their overall care. Following is a summary of the results:

Significant improvement in patient and health care provider satisfaction, driven by

  • A decline of approximately 80% in consultation waiting time
  • A decline of almost 90% in surgery waiting time
  • A decline of 30% in hospital stay
  • Enhanced patient accountability and education
  • No increases in costs per case from time of referral to discharge from hospital—the same dollars provided faster, more comprehensive and satisfying care.

Based on these outstanding interim results, the ABJHI Hip and Knee Replacement model is now being rolled out as the standard of care in three of Alberta’s largest health regions – Capital, David Thompson, and Calgary.  The ABJHI will issue a comprehensive report on results of the pilot in December 2006, including a 3-month follow-up of all patients who participated in the Hip and Knee Replacement Pilot. 

The ABJHI’s innovative evidence-based health care model has gained national attention in Canada.  As a result, ABJHI has given educational workshops in other provinces and health care regions describing the development and implementation of its new model for hip and knee replacement care.