Reducing the Pains of Change--Total Knee Replacement Postoperative Infection Prevention

Utilizing PDSA, the hospital's multidisciplinary team utilized evidence based best practices to enhance the patient care experience associated with total knee replacement surgery through improved patient education and improved surgical outcomes, including a reduction in the risk of postoperative infections.

Innovations included developing a surgical bath protocol and patient education packet, and a pre-op total joint class, curriculum and guidebook, including the creation of total knee replacement surgery information booklet.

Since 2007, these innovative strategies have led to the current KPRO rate of 0.76 infections per 100 procedures and the Joint Commission national quality core measures scores of 100 percent for prophylactic antibiotic within one hour of surgery and 96.6 percent for antibiotic discontinuation within 24 hours of surgery. Additionally, the innovations have led to a reduction in the per capita cost of care for total knee replacement surgery postoperative infections.

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)