AAOS Registry Program Blog

Guest Blogger: The Joint Commission Executive Director, Hospital Business Development, Patrick Phelan

Joint replacements are on the rise and will only increase over the next decade. When serving these patients, you want to be sure your team is providing consistent, quality care across the continuum. The Joint Commission Advanced Certification for Total Hip and Total Knee Replacement (THKR) is a way to put in place a framework for consistency reducing variation, risk, and improving patient outcomes through clinically proven evidence-based standards.

Did you know? Participation in the American Academy of Orthopaedic Surgeons (AAOS) Registry Program offers a wide variety of data reuse opportunities including requirements for quality certification programs, federal quality initiatives, insurer's distinction programs, and state collaboratives. As a participating site, unlock all the benefits of your registry data by reviewing more than a dozen data application opportunities below.

Since The Joint Commission and the American Academy of Orthopaedic Surgeons (AAOS) announced their Advanced Total Hip and Total Knee Replacement (THKR) collaboration in September, The Joint Commission has announced it will implement a new requirement for hospitals, critical access hospitals, and ambulatory surgery centers (ASCs). The new requirement appears in the program-specific eligibility criteria, as well as Performance Measurement (DSPM) Standard DSPM.4, Element of Performance (EP) 2b in the Comprehensive Certification Manual for Disease-Specific Care. This blog addresses an update to The Joint Commission requirements.

Upon publication of the new requirement, hospitals and ASCs began asking which registries would be sufficient to fulfill it. Based on questions from organizations about registries that meet the new THKR certification requirements, The Joint Commission researched registry options and convened discussions with the AAOS and other stakeholders.

Based on information collected, The Joint Commission has revised the program-specific requirement and DSPM.4, EP 2b to require that THKR-certified organizations participate in the American Joint Replacement Registry (AJRR). This requirement revision is designed to improve the safety and quality of services for patients electing to undergo total joint arthroplasty by selecting a robust and well established national registry to provide benchmarked performance data that can drive care processes improvements.

On September 26, 2018, the American Academy of Orthopaedic Surgeons (AAOS) announced collaboration with The Joint Commission to incorporate AAOS clinical expertise into standards development and performance measurement requirements for Total Hip and Knee Replacement (THKR) Certification. The Joint Commission established the voluntary advanced certification in 2016 for accredited hospitals, critical access hospitals, and ambulatory surgery centers (ASCs) seeking to elevate the quality, consistency, and safety of their services and patient care.

The American Joint Replacement Registry (AJRR) became part of the American Academy of Orthopaedic Surgeons (AAOS) on October 17, 2017. As AAOS embarks on registry expansion and integration with the AJRR, they remain dedicated to improving the quality of musculoskeletal care that orthopaedic surgeons can deliver. Within this mission, the AJRR, the national hip and knee registry, has maintained a U.S. Centers for Medicare & Medicaid Services (CMS)-approved qualified clinical data registry (QCDR) since 2014. Now known as the AAOS Orthopaedic Quality Resource Center, this unit has been designated by CMS as a QCDR for 2018.

The Joint Commission's mission: to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.

Joint Commission Certification is widely recognized as an indicator of exceptional quality in health care by both professionals and the public.

In the specialty of orthopaedics, the American Joint Replacement Registry (AJRR) has been one of The Joint Commission's primary registry stakeholders. AJRR and The Joint Commission began to formally collaborate in 2012 by establishing productive discussions that were focused on recognizing hospitals that submitted data to AJRR. The AJRR Public Advisory Board membership includes a representative from The Joint Commission. AJRR continues to have an active collaborative relationship with The Joint Commission on a variety of topics including their Orthopaedic Joint Replacement Certification process and making registry participation a key component.

Both organizations also collaborate with the International Consortium of Orthopaedic Registers (ICOR), the International Society of Arthroplasty Registries (ISAR), and the Physician Clinical Registry Coalition among others.

Together, Joint Commission Certification and AJRR participation make the whole greater than the sum of its parts, as the hospital and ambulatory surgery center (ASC) quality improvement subsections below demonstrate. This blog's conclusion looks at how to apply what you've learned to your organization's future certification, data registry, and quality improvement efforts.