Hip and Knee Osteoarthritis

ABJHI’s roots began in 2004 in raising the quality of care for hip and knee replacement patients by designing a provincial care path based on best evidence, in collaboration with the Alberta Orthopaedic Society, representing the province’s orthopaedic surgeons, and with provincial health authorities. The care path was tested in a provincial pilot in 2005-06, which was managed by ABJHI.

Continued today with the Bone and Joint Health Strategic Clinical Network (BJH SCN) and ABJHI, the provincial hip and knee replacement care path sets out the practices and protocols for treatment, beginning with referral by a primary care provider to a specialist at a hip and knee clinic, and extending through: assessment by a specialist, a plan to get surgical patients to their optimal readiness, surgery, recovery, and rehabilitation in the community. For those patients not deemed appropriate for surgery or for those that decline surgery, a treatment plan is also developed.

The hip and knee replacement care path continues to be updated annually based on evidence-based oversight from a designated Clinical Committee (comprised of Alberta’s top orthopaedic surgeons endorsed by the Alberta Orthopaedic Society), in coordination with the BJH SCN and ABJHI.

Hip and knee replacement care in Alberta is measured using a framework designed by ABJHI in collaboration with the Clinical Committee, built around the six essential dimensions of health care quality. ABJHI analyzes and presents aggregated and de-identified performance measurements for Alberta health care zones, hospital sites and individual surgeons across the province, which compare against provincial benchmarks (in the case of surgeon reports, against aggregated scores for the surgeon’s peer group after adjusting for the complexity of the cases).

Reports flag indicators such as wait times, patient outcomes and health complications, which are then used by the network of care providers to inform continuous quality improvement activities. The measurement framework and patient guides are also reviewed and updated annually to reflect changes in evidence and care practices.

The Hip and Knee Osteoarthritis Program is also shifting focus towards the upstream (conservative) management of osteoarthritis symptoms in hips and knees. Through growing partnerships with patients, patient organizations, and community care providers, patient-oriented options and education will be the focus for managing osteoarthritis, using evidence and informed clinical practices. A proof of concept is underway for a new conservative care program evaluating disease progression and patient satisfaction for adults with hip and knee osteoarthritis.The successful quality improvement processes and learnings from the surgical hip and knee replacement program serve as the foundation of this expanding initiative.

Find out more on the osteoarthritis program by visiting the BJH SCN website.