Joint Replacement

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McKesson Readmissions Resource™

There are more than 1 million total joint replacements performed in the United States annually.¹ For providers, making sure these patients are able to recover fully and without complications is key to providing the best care possible, and improving their quality of life.

Our guide outlines seven common causes for readmission following a joint procedure – surgical site infections, deep vein thrombosis, pneumonia, urinary tract infections, pain management, fall prevention and sepsis – as well as best practices and products to help prevent them.

Surgical site infection prevention products

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Professional Disposables #X12048

Impregnated Nasal Swabstick Kit Profend® Povidone-Iodine NonSterile 4 per Pack
B. Braun #S8004-5264

Replacement Preparation Sodium Chloride, Preservative Free 0.9% IV Solution Flexible Bag 100 mL Fill in 150 mL
3M #8630

Skin Prep Solution 3M™ DuraPrep™ 26 mL Foam Applicator 0.7% / 74% Strength Iodine Povacrylex / Isopropyl Alcohol NonSterile

Reducing outpatient joint readmissions

Under the Ambulatory Surgical Center Quality Reporting (ASCQR) Program, ASCs report quality of care data for standardized measures to receive their ASC annual payment rate.
Most joint procedures are paid with insurance bundles which include a 90-day post-operation period.
An unplanned hospital visit seven days after an orthopedic procedure in a surgery center can negatively affect reimbursement.⁴

Deep vein thrombosis prevention products

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McKesson Brand #84-03

Anti-embolism Stocking McKesson Knee High Large / Regular White Inspection Toe
DJO #3050

DVT Compression Therapy Cuff VenaFlow® Elite Calf One Size Fits Most
DJO #30B-S

DVT Pump VenaFlow® Elite

Risk factors

Proper patient selection is key in improving quality and safety outcomes in an outpatient program.

Modifiable risk factors to improve outcomes

There are a number of modifiable risk factors that contribute to poor clinical outcomes following a total joint replacement. These are some key patient selection considerations:

Obesity
Diabetes
Staphylococcus aureus colonization
Smoking
Family or patient history of deep vein thrombosis (DVT) or pulmonary embolism (PE)
Venous thromboembolic disease
Cardiovascular disease
Neurocognitive, psychological and behavioral problems
Physical deconditioning and comorbidities affecting ambulation
Medications
Living conditions
Friends and family committed to helping with patient recovery

Complications of these risk factors

Higher pain scores
Higher incidence of urinary tract infection
Higher rate of surgical site infections
Increased incision-related and cardiopulmonary complications
Cardiac events and stroke
Increased risk of falls
Patients tend to have a length of stay greater than 24 hours, which requires transfer to an acute or rehab facility