What is required to join the IJRR?
Physicians who are part of the Institute need to participate in research and education; they must also meet certain minimum educational and practice criteria. The criteria have many elements that help assure a physician’s commitment to the practice of joint replacement, research and education.
Specifically, physicians must perform a minimum of 150 joint replacements per year. Washington believes this is the minimum number which can be credibly justified under the goals of the Institute. If doing the math, in order to meet the minimum, a physician would have to perform 2.88 joint replacements per week. This is a modest requirement given the goals of the Institute. The volume requirement is also based on clear evidence that higher volume is associated with improved patient outcomes. Improved patient outcomes can translate to lower patient lengths of stay and improved recovery. Lower lengths of patient stays and improvement of recoveries is exactly what the government and payers are saying is needed to help reduce federal health care spending.
Additionally, participating physicians must perform 75% of their joint replacements at Washington Hospital. This requirement helps assure proper control of research protocols, which is essential when performing research.
Who is currently a member of the IJRR?
Currently, there are two physicians, Dr. John Dearborn and Dr. Alex Sah, who are part of the Institute for Joint Restoration and Research. Their devotion to the practice of joint replacement and commitment to improving patient outcomes through research and education has enabled Washington Hospital to successfully execute this world-class Institute. Drs. Dearborn and Sah have also been named Medical Co-Directors of the Institute for Joint Restoration and Research. Dr. John Dearborn and Dr. Alex Sah perform 85% of the joint replacement procedures at Washington.
Orthopedic physicians who do not wish to participate in the Institute or who do not qualify may continue to provide joint replacement services at Washington Hospital. Neither their medical staff membership nor their clinical privileges are impacted. Their patients have their procedures performed in the same hospital operating rooms and receive the same standard of care provided by the same highly qualified nurses and rehabilitation team that staff the Institute. As a matter of fact, non-Institute patients also benefit from the clinical improvements that are a result of research from our Institute and other like programs.
How Many Orthopedic Surgeons Perform (Hip and/or Knee) Joint Replacement Surgery at Washington?
Other than Drs. Dearborn and Sah, there are currently five other surgeons performing joint replacement at Washington Hospital, and another two with privileges to perform joint replacement who currently do their procedures at another hospital. The five active surgeons together perform an average of two joint replacements a week.
What about surgeons who choose not to join the IJRR?
Orthopedic physicians who do not wish to participate in the Institute or who do not qualify may continue to provide joint replacement services at Washington Hospital. Neither their medical staff membership nor their clinical privileges are impacted. Their patients have their procedures performed in the same hospital operating rooms and receive the same standard of care provided by the same highly qualified nurses and rehabilitation team that staff the Institute. As a matter of fact, non-Institute patients also benefit from the clinical improvements that are a result of research from our Institute and other like programs from throughout the Country.
Where are patients placed if their physician is not a member of the IJRR?
Patients of physicians who are not participating in the IJRR receive the same pre-operative care testing, have their procedures performed in the same hospital operating rooms and receive the same standard of care provided by the same highly qualified nurses and rehabilitation team that staff the Institute. After surgery, patients will be placed on the 6th floor of Washington Hospital in a private room or another private patient room elsewhere in the hospital where the same standard of care is provided.
Physical access to the Center for Joint Replacement building is automatic for IJRR patients, but patients of non-participating physicians typically recover on the 6th floor of Washington Hospital. Space in the Center for Joint Replacement building for non IJRR patients is considered when patient rooms are available and needed.
Doesn’t this create a “two-tiered” system of care?
No. The implementation of the IJRR provides a different approach to joint replacement care; there are not different tiers of care. Patients, as well as doctors, have the option of participating in the care that best suits their needs and/or situation.
Can the admission criteria be changed?
As is often the case with any new approach, Washington Hospital will continue to assess criteria and make adjustments based on the needs of patients, physicians and staff and in the best interest of the quality of care provided and the economic health of Washington Hospital Healthcare System.
What is the difference between the IJRR and the outpatient clinic also located in the building?
In addition to the Institute, the hospital also has a 1206(d) clinic that is located in the new building. The clinic is a department of the hospital and allows the organization to have a controlled outpatient environment that supports the research goals of the Institute. Because the clinic is a department of the hospital, policies and procedures are determined by the hospital and the clinic staff is directly employed by Washington Hospital. As is typical for such specialty clinics, the hospital needs a physician or physician group to provide professional medical services to its patients. A professional service agreement was established with the Dearborn Sah Institute for Joint Restoration to provide medical services to clinic patients. The clinic is not a private practice of Drs. Dearborn and Sah, as they bill for the professional services provided by them and Washington bills for the facility fee and any ancillary services such as radiology and lab services.
Will Medi-Cal and other government aided medical insurance benefits be accepted?
Medi-Cal patients are seen at the clinic. There is confusion about this topic because the physicians who provide professional services currently do not have a Medi-Cal contract. When Medi-Cal patients seek care at the clinic, the physicians negotiate with Medi-Cal to provide services to those patients that need to have surgery.
How does this program benefit Washington Township Health Care District?
The IJRR benefits the District in two very important ways: First, it provides access to world class care and innovation right here in our back yard. Second because the Institute is also a regional program that draws patients from outside the District. By caring for patients from outside of the District, the program generates income for the hospital from outside the District, positively contributing to the hospital’s bottom-line and ability to provide other programs and services that meet the community’s medical and health care needs.