Health systems take steps to improve knee replacement by learning from one another

A consortium of leading U.S. health systems has found wide variation in surgery times, hospital lengths-of-stay, discharge dispositions, and in-hospital complication rates for knee replacement procedures, and is taking steps to close the gaps, according to a study in Health Affairs.

For the study, the High Value Healthcare Collaborative, a group of U.S. health systems whose founding members include Cleveland Clinic, Denver Health, Intermountain Healthcare, the Mayo Clinic, and The Dartmouth Institute for Health Policy and Clinical Practice, examined administrative data to examine differences in total knee replacement across institutions.

The results showed that higher surgeon caseloads were associated with shorter lengths-of-stay and operating time, as well as fewer in-hospital complications.  The one healthcare system with a dedicated knee replacement team had the shortest operating time, which leads to fewer complications and more cases done per day.  Health systems in the collaborative are now using lessons learned from the high performing systems to improve care, including coordinated management for medically complex patients and use of dedicated teams.

(Sources: The Advisory Board Daily Briefing,, May 21, 2012; Health Affairs, May 2012; Bloomberg Businessweek,, May 20, 2012)