Total Joint Replacements

The GTA Rehab Network continues to support efforts to enhance system-wide performance for care of hip and knee replacement patients.

Over the past year, the GTA Rehab Network conducted a review of evidence and current practices with the Toronto Central LHIN’s Joint Health and Disease Management Committee. The final report and recommendations are now available.

Comprehensive review sets new directions

The Network’s review found the following:

• A high percentage of arthroplasty patients in the GTA LHINs are discharged to inpatient rehabilitation.

• Evidence demonstrates that most of these patients could be discharged home with community-based services and achieve comparable outcomes at considerably lower cost.

• Resources devoted to MSK rehab across rehabilitation hospitals could be rebalanced to:
• enhance outpatient rehabilitation for hip and knee replacements, and
• create additional inpatient capacity for other MSK rehab populations such as hip fracture patients.

• There is a need for improved triage criteria and better management of patients’ 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.

The Group is 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 Group will support hospitals in achieving the Toronto Central LHIN’s length of stay and discharge targets—80 per cent of patients discharged home within 4.4 days. This target is based on the provincial target of 90 per cent of patients discharged home, +/- 10 per cent.

Resources

• TJR Final Report and Recommendations
• TJR Triage/Admission Guidelines