Performance Measures for Advanced Certification in Total Hip and Total Knee Replacement | Joint Commission
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Performance Measures for Advanced Certification in Total Hip and Total Knee Replacement

January 17, 2018

The Joint Commission recently finalized performance measures for Total Hip and Total Knee Replacement (THKR) Certification (an advanced disease-specific care certification available to Joint Commission–accredited hospitals, critical access hospitals, and ambulatory surgery centers). Data collection for the new measures will be mandatory effective January 1, 2018, for all currently THKR-certified programs as well as those seeking initial certification.

Nearly 700,000 total hip and knee replacements are performed each year—with the demand expected to quadruple by 2030—placing these procedures among the most common surgeries performed in the United States. For the most part, these surgeries are highly successful; however, according to the Centers for Medicare & Medicaid Services, there is significant variance in the quality and cost of care for these surgeries.

To select performance measures for development, The Joint Commission worked with a Technical Advisory Panel that included experts in orthopedic surgery, anesthesia, rehabilitative medicine, internal medicine, physical therapy, perioperative nursing, social work, and joint program administration. These measures were then posted for public comment and underwent rigorous testing. The final four THKR measures address patients undergoing a total hip or a total knee replacement in the inpatient or outpatient setting and comprise the following:

  • THKR-1   Regional Anesthesia
  • THKR-2   Postoperative Ambulation on the Day of Surgery
  • THKR-3   Discharged to Home
  • THKR-4   Preoperative Functional/Health Status Assessment

Organizations will be required to collect monthly data for the four standardized measures and to report the data on a quarterly basis to The Joint Commission via the Certification Measure Information Process (CMIP) on the Joint Commission Connect™ secure extranet site.

Measure specifications for the four mandatory THKR measures are detailed in two separate implementation guides for inpatient and outpatient data collection: 

Total Hip and Total Knee Replacement Inpatient Performance Measurement Implementation Guide, Version January 2018

Total Hip and Total Knee Replacement Outpatient Performance Measurement Implementation Guide, Version January 2018

The slides from the 9/28/2017 THKR Abstraction Training Webinar can be found here.

The transcript of the Questions & Answers from the 9/28/2017 THKR Abstraction Training Webinar can be found here.

The recording from the Abstraction Training Webinar held on 9/28/2017 is available for playback here.

Questions related to the THKR performance measures may be directed to Paula Farrell, BSN, RN, CPHQ, Associate Project Director, Department of Quality Measurement, The Joint Commission, at pfarrell@jointcommission.org

 
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