Dedicated nurses in the OR
It's important for surgeons to be efficient with their time in the operating room, and the study found that experienced surgeons did so. But the organization with the shortest operative times was the only one with a dedicated team of knee replacement surgery nurses. "At most other hospitals, the nurse is in orthopedics one day, in urology the next, and the next day somewhere else. We have to remember that the Honda mechanic fixes it faster than a mechanic who sees a Honda one a year,"Tomek says.
Other procedures are on tap for similar multi-health system analysis, including diabetes, congestive heart failure, depression, spine surgery, labor and delivery, asthma, hip surgery, and bariatric surgery.
The collaborative selected knee replacement surgery to evaluate first because the lifetime risk of knee osteoarthritis is 50%, and because in 2008, total knee replacement inpatient costs exceeded $9 billion, "the highest aggregate cost among the 10 procedures for which demand is growing the fastest," according to the paper.
Each procedure costs somewhere between $20,000 to $25,000 in technical and professional fees, adjusted for geographic variables.
"Between 2005 and 2030, the demand for primary knee arthroplasty in the United States is projected to grow by 673% or 3.48 million procedures annually,” according to the paper.