Changing the rehab path for total joint replacement patients

Date: December 5, 2011 Author: Mantis System Categories: Spotlight 1

The final report and recommendations of the Network’s review of evidence and current practices for hip and knee total joint replacement is now available.

The review, conducted with the Toronto Central LHIN’s Joint Health and Disease Management Committee, confirmed that a high percentage of arthroplasty patients in the GTA LHINs are discharged to inpatient rehabilitation. However, the evidence demonstrates that most could be discharged home with community-based services and achieve comparable outcomes at considerably lower cost.

The Report indicates that resources devoted to MSK rehab across Toronto Central and GTA LHIN hospitals could be rebalanced to enhance outpatient rehabilitation for hip and knee replacements and to create additional inpatient capacity for other MSK rehab populations such as hip fracture patients.

Among other findings, the report identified the need for improved triage criteria and better management of patient’s expectations regarding post acute rehabilitation and discharge to home. A Network sub-committee has developed new guidelines to address this need.

Implementing the Report

The Toronto Central LHIN has established an MSK Implementation Group to move the report’s recommendations forward—co-chaired by Dr. James Waddell, Chair of the Ministry of Health and Long-Term Care Orthopaedic Expert Panel, and Anne Marie MacLeod, Operations Director at Sunnybrook health Sciences Centre. The GTA Rehab Network is also a member.

The MSK Implementation Group will support hospitals in achieving the LHIN’s length of stay and discharge targets for the arthroplasty patient population—80 per cent of patients discharged home within 4.4 days.