Continuous quality improvement program for hip and knee replacement

Am J Med Qual. 2015 Sep-Oct;30(5):425-31. doi: 10.1177/1062860614540512. Epub 2014 Jun 23.


Improving quality of care and maximizing efficiency are priorities in hip and knee replacement, where surgical demand and costs increase as the population ages. The authors describe the integrated structure and processes from the Continuous Quality Improvement (CQI) Program for Hip and Knee Replacement Surgical Care and summarize lessons learned from implementation. The Triple Aim framework and 6 dimensions of quality care are overarching constructs of the CQI program. A validated, evidence-based clinical pathway that measures quality across the continuum of care was adopted. Working collaboratively, multidisciplinary experts embedded the CQI program into everyday practices in clinics across Alberta. Currently, 83% of surgeons participate in the CQI program, representing 95% of the total volume of hip and knee surgeries. Biannual reports provide feedback to improve care processes, infrastructure planning, and patient outcomes. CQI programs evaluating health care services inform choices to optimize care and improve efficiencies through continuous knowledge translation.

Keywords: continuous quality improvement; health care quality improvement; performance measures; quality improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alberta
  • Arthroplasty, Replacement, Hip / methods*
  • Arthroplasty, Replacement, Knee / methods*
  • Critical Pathways
  • Evidence-Based Medicine / methods
  • Humans
  • Patient Care Team / statistics & numerical data
  • Quality Improvement*
  • Surgeons / statistics & numerical data
  • Total Quality Management*