To maintain standards of excellence and continuously improve their outcomes, specialized joint replacement centers must develop, implement, and sustain specific performance improvement activities. This article describes the activities at one. Midwestern healthcare system's joint replacement center related to three disease-specific performance improvement measures: fall prevention, preoperative education, and pain management. Specific steps in the process for each measure are described. These include current-state analyses, goals established, the use of Plan–Do–Study–Act (PDSA) methodology to identify and implement appropriate interventions, and the use of the Six Sources of Influence model to promote successful change. Outcomes, lessons learned, and suggestions for replication by other institutions are discussed.
Deborah Cress, MSN, RN, NE-BC, Director of Orthopaedic Services, Spectrum Health, Grand Rapids, MI.
Linda Hansen, MSN, RN, ONC, Clinical Nurse Specialist Orthopaedic Services, Spectrum Health, Grand Rapids, MI.
JoAnne Pelton, BSN, RN, ONC, NE-BC, Nurse Manager, Orthopaedics, Spectrum Health, Grand Rapids, MI.
The authors have disclosed that they have no financial interests to any commercial company related to this educational activity.