Program Background

History

The Hip and Knee Osteoarthritis Surgical Program began in 2004 with the Alberta Hip and Knee Replacement project, which conducted a randomized control trial testing a new model of care against the standard of care in Calgary, Edmonton, and Red Deer. In a ground-breaking coordinated effort, orthopedic surgeons, the former health regions in Edmonton, Calgary and Red Deer, and IIHO (then known as the Alberta Bone and Joint Health Institute) teamed up to pilot the new care path, setting up multidisciplinary hip and knee clinics in the three cities with funding from Alberta Health.

This new model included the design and implementation of an integrated Hip and Knee Surgical Care Path and Measurement Framework to standardize best practices and evaluate performance. The framework included key performance indicators (KPIs) in each of the Health Quality Council of Alberta’s six dimensions of health care quality: safety, accessibility, acceptability, effectiveness, efficiency, and appropriateness. The pilot was a staggering success story. Compared to a control group, patients in the new care path had less pain and greater ability to perform daily activities. They were home from hospital sooner. They were more satisfied with their care. The pilot also showed wait times could be cut dramatically.

The success of this pilot sparked a provincial initiative, aided by the foundation of Alberta Health Services in 2009, to spread and scale this new model of care across the province. The Bone and Joint Health Strategic Clinical Network (BJH SCN), a network of people who were passionate and knowledgebale about bone and joint health, formed and the Hip and Knee Osteoarthritis Surgical Program became one of their leading programs for improving the model of care for Albertans with osteoarthritis.

Under the BJH SCN, a Hip and Knee Working Group brought together health zone and clinical leaders, arthroplasty teams and partners from across the province to improve care for patients undergoing hip and knee replacement. The Working Group was a multi-disciplinary and multi-site team providing community and acute care for patients with operable osteoarthritis in hip or knee joints. They guided, continuously improved and implemented the standardized clinical practices, protocols, scopes of care and services for Albertan hip and knee arthroplasty, using the surgical care path and direction of a clinical committee as guidance. The Clinical Committee comprised of Alberta’s top orthopedic surgeons, provided an independent, expert review to the medical and quality improvement work of the Working Group. They made clinical and quality measurement decisions, using evidence and informed clinical judgement to set the standard of the best possible quality of care for the patients.

With the refocusing of Alberta’s healthcare system announced in November 2023, the program is evolving. Today, it continues with a revised structure under Acute Care Alberta.