Quality improvement is a big deal to us at OrthoCarolina. In fact, we have a team that works only on care improvement programs and maintaining quality and coordinated care. In healthcare organizations nationwide, surgeons have traditionally measured how patients have done after surgery based mostly upon their opinion, using terms like good, fair and poor. The direction OrthoCarolina is headed is one that measures how patients are doing based on both the provider and patient’s perspective. By getting an unbiased outcome from the patient we’re able to better to pinpoint and track your progress.
Why is it important to track your progress after surgery?
By more closely following your progress post-op and getting your direct input, we can intervene when patients are not doing as well as they should be. Our surgeons can also discover opportunities to improve upon the care of our patients, in both surgical techniques and various protocols.
What is the process for this program?
This clinic-wide, specific process improvement is currently being rolled out at the OrthoCarolina Spine Center and will soon be implemented company-wide.
Patient progress is tracked through online surveys. Besides individual progress these surveys also help us compile data for various types of surgeries and procedures and how the patient population as a whole is progressing. Surveys will generally come in structured intervals when they are relevant. For example we might send you surveys before surgery, three months, six months, one year, five years and 10 years after.
What you fill out in the surveys will be specific to the area of the body and type of operation you had. You’ll share information with us about the individual body part and overall function; what you could and could not do before versus now. It will detail your individualized care.
How long do you plan to track any one patient?
Up to 30 years.
What challenges are there to this method of tracking patient progress?
Most people nowadays are overwhelmed with emails and electronic and paper forms to fill out. We want our patients to understand why it is important that they fill the surveys out and take the time to complete them. Ultimately we are tracking them for their benefit long-term.
At the Spine Center, where we’ve already implemented the program, we are sharing survey information with our patients so that they can see how they are doing before and after surgery. They can also access data that shows them how others with their same type of surgery are faring, so they can see how they stack up against their peer group. Our hope is that if their improvement is ahead of or behind the curve it will motivate them to fill out the surveys down the line and also to be active in their care with their surgeon. We want patients to feel enabled to go to their surgeon and ask why they are not doing as well as their peers if that is the case, so they can determine together what to do better or differently.
What is unique about this program?
Patient-reported outcomes help shift the focus onto the success of the patient as a whole and not simply the procedure. It is based on the patient’s perception of their surgery and recovery.
We are studying pain and function long-term. Very few medical organizations are sharing this type of specific process improvement information with patients. It is unique in the Charlotte market and OrthoCarolina is only one of a few centers nationally offering it to patients. Instead of just monitoring you for 30 days after surgery, we follow you for 30 years after surgery to make sure you are functioning at the level you want. Patients become part of the conversation rather than keeping that information just to the medical organizations. It’s an open relationship in which you give us periodic updates on your condition and we in turn provide you your data and the data of others like you.
Patients always have a voice in their own satisfaction when it comes to any orthopedic or surgical outcome, but this program enables patients to continue to work with their physician to track functionality over time.
Leo Spector, MD is a spine surgeon with the OrthoCarolina Spine Center and part of the OrthoCarolina quality initiative.