Safer, shorter recovery at home.

Knee and hip replacements are some of the most common operations in the world. In 2018, doctors performed over one million procedures in the U.S. alone. But each time a patient is sent to a rehabilitation facility instead of home to recover after the surgery, it adds $7,000 to $8,000 to the cost.

The Michigan Arthroplasty Registry Collaborative Quality Initiative is a Blue Cross-funded statewide collaboration that pools data from facilities across the state. Participating surgeons throughout Michigan then analyze the data to find ways to improve and advance their care.

Data from the CQI showed a wide variation in patients recovering at home versus a rehabilitation center. “Some hospitals were sending fewer than 10 percent of their patients [home] and some were sending more than 40 percent,” explained Brian Hallstrom, co-director of Michigan Arthroplasty Registry CQI. “Seeing that variation made us realize, ‘Well, what are those other hospitals doing?’”

Home-based recovery can be very beneficial. Those who recover in the comfort of their own home tend to return to normal daily activities quicker. They have less exposure to illness, and they have less return to the hospital for a complication.

When Phyllis St. Michael received a double hip replacement, she stayed in the hospital for two nights each. She mostly recuperated at home, utilizing a walker and cane to regain her strength. For both surgeries, she only experienced a couple weeks of downtime.

“I work out,” she declared. “I go to the Y[MCA] two, three times a week. I can do my exercises and walk a lot. It’s great to be able to do all those things and not be in pain.”

The information acquired from the CQI is helping to make Michigan one of the best places to have a joint replacement. Not only is it reducing admissions to rehabilitation facilities and bettering outcomes, it’s saving money.

“There is a huge opportunity for us to really improve what we’re doing,” said Hallstrom. “But we have to pay attention and learn from everything we’ve done in the past.”

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