McKay-Dee Hospital Awarded Advanced Certification for Total Hip and Total Knee Replacement

The disease-specific certification helps drive better patient care by standardizing best practices in orthopedic care and meeting performance improvement standards through collaboration, consistency, and a higher level of care.

"Visionary thinking and supportive leadership has led to this achievement," says Ted Aiken, nurse manager of the McKay-Dee joint and spine program. McKay-Dee is the second program in Utah to receive this advanced certification.

The certification was led by Evelyn Chapman, a clinical program coordinator at McKay-Dee who has been working at the hospital for 28 years. Evelyn managed a workgroup that focused on the quality standards set by the Joint Commission, some of which were already in place at the hospital due to an initial total joint replacement certification five years ago.

"We couldn't have done this without Evelyn's leadership in the certification and the collaboration of the entire hospital," says Ted. "Everyone worked so hard and there are many people involved. This is an accomplishment of several departments, along with the Calton/Harrison Orthopedic Clinic."

Ted mentions Thomas Calton, MD, total joint program medical director, Todd Grunander, chief of the department of surgery and medical director of musculoskeletal services, and Travis Hendry, MD, chief of the orthopedic department, all helped lead the achievement.

How does the advanced certification lead to better patient care?

Here's how patients who need a joint or knee replacement are receiving better care. Patients experience the following outcomes over 90 percent of the time:

1. Patients are discharged to home after surgery." Studies show that patients who are discharged home have better outcomes than those who go to a rehabilitation facility," says Evelyn. She says the program emphasizes good health in patients prior to surgery and education for patients to know the expectation in advance.
2. Patients are given a spinal anesthesia most of the time, rather than general anesthesia. This leads to better pain relief and movement post-surgery, and a reduction in opioid use post-surgery. A nerve block is used with knee patients, as it also reduces opioid use and length of stay.
3. On the same day as surgery, patients work with a physical therapist to stand up and walk. "We've standardized early rehabilitation as it drives the best outcomes," says Ted. This leads to less swelling, better pain control, reduced risk of blood clots, and other improvements. This standard has already been in place for the past five years at McKay-Dee.
4. Patient outcomes are kept in a database, managed by the Centers for Medicare and Medicaid to support quality, efficient care. "This registry analyzes what life was like before and after surgery and to drive best practices throughout the nation," says Ted. "Medicare services are comparing us to cities like Atlanta or Philadelphia. We've reached a level where we're leaders on a national scale in joint replacement."

"This program is not only impressive, but inspiring," is the feedback received from the two-day Joint Commission visit, provided by a retired orthopedic surgeon who carefully examined everything in the program.

"We try really hard to be the destination for joint replacement,” says Ted. "We're helping patients from Southern Idaho, Wyoming, Nevada, and Northern Utah."
The hospital has been certified in Total Joint Replacement since fall 2013. This advanced certification received in 2018 validates the program as a nationwide leader in patient-centered orthopedic care.

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