Systematic Arthroplasty Follow-up at CSSS du Cœur-de-l’Île

In May 2003, CSSS du Cœur-de-l’Île was designated the regional centre for hip and knee replacement. This practice was put in place to ensure that best clinical practices for hip and knee replacement were being used in the CSSS. Our objective was to increase the volume of arthroplasty-related activities which, before 2003, totalled 65 surgeries per year. An Arthroplasty Committee was established as of 2003 to ensure the program proved effective and produced results. The Committee meets on a monthly basis and when a problem arises, action plans are initiated. Indicators followed on a monthly basis include: • average length of stay; • number of patients returning home; • wait times for arthroplasty; • complication rate; • infection rate. In July and August 2011, a satisfaction survey entitled “Our success… is your satisfaction!” was also conducted among all hip and knee replacement patients to evaluate their satisfaction regarding the pre-admission process. The expected Ministry target for average length of stay is of 5 to 7 days. In 2002-2003, CSSS du Cœur-de-l’Île had an average length of stay of 11.89 days. In 2007-2008, it was reduced to 7.54 days. Today, the average for hip and knee joint replacements is 3 days. At the beginning of the project, 22.8% of arthroplasty patients returned home. In 2013, 89.3% of them return home. 2005-2006: 53.4%. 2007-2008 : 73.6%. 2012-2013 Period 8: 89.3%. Wait times for arthroplasty are above the 90% performance target. Since 2009-2010, the delay for hip replacement is 2 months, and 3 months for knee replacement. 2011-2012 (less than 6 months wait) – Total knee prosthesis: 96.8%; Total hip prosthesis: 94%. 2012-2013 (less than 6 months wait) – Total knee prosthesis: 96.1%; Total hip prosthesis: 99.1%. More than 953 arthroplastic surgeries were done throughout the 2012-2013 fiscal year. The revision of systematic arthroplasty follow-up has allowed for the rapid collection of data related to decreasing wait times and increasing the number of patients returning home, and has greatly facilitated client flow through the care continuum. The establishment of a multidisciplinary team and the participation of all professionals involved have greatly contributed to the work that has been realized.