New hips, knees, distinction

Trinity Hospital is the place to go if you are in need of knee or hip replacement. One of the reasons is because Trinity has recently been designated a Blue Distinction Center Plus for knee and hip replacement, a newly expanded designation from the Blue Cross Blue Shield Association in conjunction with Blue Cross Blue Shield of North Dakota.

The Blue Distinction program was established in 2006 and has given patients, medical providers and employers a means to identify hospitals that deliver high quality care in several specialty areas, including knee and hip replacement. Blue Cross Blue Shield Association recently announced the expansion of the Blue Distinction to include new cost-efficiency measures – the “Plus” part of the title – along with more quality measures focused on improved patient health and safety.

Trinity Hospital first achieved Blue Distinction honors for knee and hip replacement in 2009, about a year after it launched its Joint Replacement Center, an 11-bed unit in the east wing of the hospital’s sixth floor Ortho/Neuro Unit. The opening of the center in 2008 represented a new approach to knee and hip replacement surgery, one that features best practices in joint care and a group approach to patient care and recovery.

More than 460 facilities nationally have been recently recognized as Blue Distinction Centers Plus for their expertise and cost efficiency in delivering specialty care, according to a press release from Blue Cross Blue Shield Association. Research has confirmed that facilities that receive the Blue Distinction Center Plus label demonstrate better quality and improved outcomes for patients, with lower rates of complications and readmissions. Blue Distinction Centers Plus are also more than 20 percent more cost-efficient than their peers.

This is the fourth year in a row that Trinity Health has been named a Blue Distinction Center for knee and hip replacement by the Blue Cross Blue Shield North Dakota, according to Renee Fransen, Joint Center coordinator for Trinity Health.

“Basically, it signifies our facility met national established quality care and outcomes,” said Fransen. “We are a center of excellence and in knee and hip replacement and that’s what the Blue Distinction means – that we are a center of excellence.”

The Joint Center went through a somewhat lengthy process in order to gain the Blue Distinction Center Plus designation. The center applied through Blue Cross Blue Shield, filled out a 50-page survey and sent the data to Blue Cross Blue Shield. Then Blue Cross Blue Shield looked through the materials, Fransen explained. The Joint Center has to total 100 total knee or hip replacement surgeries – at least 25 per year – in order to be qualified, she added. Fransen also said that the surgeons have to be board-certified and the Joint Center tracks patient outcomes, which are then sent to Blue Cross Blue Shield for analysis. Blue Cross Blue Shield informs the Joint Center if it will receive the honor.

For patients in the Joint Center, the Blue Distinction Plus designation means that the Joint Center is not only a center of excellence, but they are also efficient in what they do and will deliver high quality to their patients, Fransen said.

“We’re the only actual joint replacement center where there’s a set standard procedure that everyone goes through,” Fransen noted.

The length of time that patients stay in the hospital after replacement surgery is two to three days, Fransen said. Surgeries for knee or hip replacement are only on Monday or Tuesday, she continued, and patients are encouraged to move around every hour. Then they go home with pain medication and exercises to do.

“We get them up and exercising faster and they recover faster, and that’s cost-effective,” Fransen said.

Before Trinity gained the Blue Distinction Plus designation, however, patients stayed in the hospital for longer than three days. Darren Armstrong, director of Therapy Services for Trinity Health, said the average length of stay for knee and hip replacement for patients prior to introducing the Joint Replacement Center was approximately 4 3/4 days for knees and 4 1/4 days for hips.

Fransen said being designated with Blue Distinction Plus makes them focus on quality outcomes of patients and that what they do will be more beneficial to patients.

“Patients will trust that we’ll provide care for them when they see the Blue Distinction Plus label,” she said.

Additionally, when patients go through the pre-operation classes, they are told about the Blue Distinction Plus label, Fransen said. Some patients said they have looked online and the plus label has helped them decide to come to Trinity for surgery instead of going to Bismarck or Fargo.

“The Blue Distinction Plus label allows patients to know we’re dedicated to the care that we deliver to them,” she said.