Joint replacements are on the rise. During the 10-year period ending in 2003, joint replacement surgeries increased by more than 50 percent. Many of these patients, not surprisingly, used post-acute rehab with services most frequently provided in Inpatient Rehabilitation Facilities (IRFs) or Skilled Nursing Facilities (SNFs).
Admitting joint replacement patients to IRFs, however, has become very controversial. Some wonder if the intensive therapy IRFs provide is medically necessary. There is also debate over what type of care provides which patients the best outcomes? These are questions that Dr. Gerben DeJong, Senior Fellow at NRH, and Dr. Susan Horn, Senior Scientist at the Institute for Clinical Outcomes Research (ICOR) in Salt Lake City, want to help answer.
On September 22, 2005, NRH and ICOR officially launched Joint Replacement Outcomes in IRFs and Nursing Treatment Sites (JOINTS), an unprecedented 24-month study focused on post-acute management of patients with hip and knee replacements in IRFs and SNFs. The purpose of the JOINTS Study is to identify the types of joint replacement patients best served in each type of post-acute facility, taking into account the types of services and therapies available in both care settings. Twenty different facilities and 2,800 patients across the country are expected to enroll in the study.
Individuals participating in the study include OT Katoshe Bastion, PT Dawn Haskell, and RN Mary Ann Morrison from Greenbriar, participants include RN Joann Furbush, PT Laura Jones, and OT Kirk Orton from Crosslands, we have RN Sally Alarin, OT Ryan Marasigan, and PT Alice Presley from Valley Gardens, . Additionally, Peoplefirst Rehab Clinical Specialists Jane Klugman and Luanne Cunningham will be responsible for collecting patient data from medical records and submitting to the JOINTS website for compilation. The team is focusing on best practices as it gathers and examines data. This approach identifies practice patterns associated with the best outcomes across different types of patients and facilities.
The JOINTS Study has been designed to provide important "practice-based evidence” needed in shaping post-acute policy and practice related to the rehab care of patients with joint replacements in SNFs and IRFs. A 20-member Policy Advisory Panel made up of payers, consumers, providers, trade groups, professional associations, government agencies, and other researchers provides ongoing input and feedback to the JOINTS Study research team. Early study results are scheduled for release in the fall of 2006 and will be followed by more detailed findings in the months thereafter.
We are thrilled to be a part of this exciting study.