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Research is Critical to Advancements in Joint Restoration

July 16, 2013

Editor's note: This is the second in a series of three articles about Washington Hospital's Institute for Joint Restoration and Research.

The Institute for Joint Restoration and Research at Washington Hospital is dedicated to improving surgical outcomes and rehabilitation for patients undergoing knee or hip joint replacement. The ultimate goal is to increase the quality of care for joint replacement patients.

The Institute was established by Washington Hospital in June 2012 to serve as a Center of Excellence with the goal of advancing the field of knee and hip joint replacement. The Institute is modeled on similar Centers of Excellence at other leading U.S. hospitals.

Research is a key element of the Institute's work to meet this goal. Using research, the Institute's physicians study how to improve the surgery process itself with the least possible invasive surgical approach, to examine which types of implants produce the best results, and to evaluate what is the best approach to rehabilitation to decrease time in the hospital and outpatient rehabilitation time.

Why is this research important? Joint replacement is a commonly performed medical procedure with more than 700,000 joint replacements performed annually in this country. Most persons know at least one other individual who has had a knee or hip replaced. As our population ages and individuals live longer and work to remain mobile and active, the incidence of joint replacement will continue to increase exponentially.

Controlling the cost of medical care is one of the critical issues facing this country. Medicare, the primary insurance program for those over 65 years of age, is threatened with financial insolvency in a few years if medical costs are not contained. Cost containment is one of the highest priorities for hospitals as well as the government.

At Washington Hospital, 80 percent of joint replacement patients have Medicare insurance. And while Medicare reimbursements to hospitals are not keeping up with the growth in medical costs, the gap between cost and reimbursements continue to widen. This means that hospitals must make every effort to contain costs while not reducing quality. The Institute at Washington Hospital not only helps advance the field of joint restoration, but its research also helps identify process improvements that yield efficiencies that are more cost effective. These efficiencies allow the hospital to continue to offer high quality joint replacement services to the residents of Washington Township Health Care District.

Patients and physicians who choose the Institute for their joint replacement surgeries agree to participate in the research program. The research program is managed by Dr. John Dearborn and Dr. Alexander Sah, the Medical co-Directors of the Institute. These physicians oversee advanced research protocols that include randomized studies, changes in medication protocols and investigations into newer surgical methods. Drs. Sah and Dearborn regularly present their work at multiple national meetings each year, and also publish their reports in peer-reviewed journals. In this way, research from the Institute influences care throughout the nation. Because these two doctors alone perform more than 1,300 joint replacement procedures annually, the volume of Institute patients provides the research program adequate data to evaluate best practices.

The Institute has established a multidisciplinary research approach to streamlining joint replacement care. This effort requires tremendous teamwork among physicians, nurses, therapists, pharmacists and administrative personnel. This team works together successfully to achieve its goal of improving care. The success of the Institute's program can be measured by the reputation it is establishing. In addition to district residents, the Institute draws patients from throughout the Bay Area and even from out of state. Many patients are referred by friends and acquaintances that have had a successful experience at the Institute.

The Institute is housed on the Washington Hospital campus in the Center for Joint Replacement building, a 20,000 square-foot facility, licensed by the State of California, with all private patient rooms. In this new facility, patients recover post-operatively in one place and in an environment conducive to a speedy recovery in a group setting. The facility also includes a rehabilitation garden, an occupational rehabilitation kitchen and other design features that promote and facilitate patient recovery.

As a Center of Excellence, the Institute is making a major contribution to Washington's Hospital's continuing goal of providing the very best care to the district's residents and to all others who come to the Institute for the innovative care available there.

For additional information about the Institute for Joint Replacement and Research, please call (510) 818-7200

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