AAOS Launches New, Improved OrthoInfo.org
OrthoInfo.org, the consumer website of the American Academy of Orthopaedic Surgeons (AAOS), has revamped and is now easier and even more authoritative for patients seeking to understand orthopedic conditions.
According to AAOS, “OrthoInfo, which receives approximately 42 million page visits each year, provides more than 525 consumer articles, videos and interactive learning modules on symptoms, causes and treatment options for a broad range of musculoskeletal conditions.
“The website offers new illustrations and multi-media resources, is more optimally organized—by body part and popular topics—and the responsive mobile design makes viewing on a phone or table more convenient than ever.”
“The new OrthoInfo empowers patients by helping them to better understand their conditions, find answers to questions and prepare for surgical procedures—anytime, anywhere,” said AAOS President William J. Maloney, M.D. “In addition, OrthoInfo is an important in-office resource and tool for our orthopaedic surgeon members, reflecting the Academy’s commitment to providing optimal patient care.”
“Our goal is to provide clear and accurate orthopaedic information in a way that patients, families and caregivers can easily understand,” said OrthoInfo Editor-in-Chief Stuart J. Fischer, M.D. “We have added new illustrations, animations and videos to supplement the articles. The new responsive design will allow viewers to access orthopaedic information on many platforms—desktop, mobile, table and smart TV.”
Finally, said AAOS; “For orthopaedic surgeons, physician assistants, nurses and other health care staff, OrthoInfo is a valuable tool in aiding and enhancing patient care.”
“The site offers images, articles and learning modules on a variety of topics—from arthritis and sports injuries, to preparing for surgery, pain management, and recovery—that can be viewed on a laptop, phone or tablet during the office visit. Staff also can email specific OrthoInfo links, or direct patients and caregivers to the website, for more information.”
Dr Fischer told OTW, “OrthoInfo gets 3 million viewers a month. We wanted our viewers and our patients to have the benefit of a modern design with easier navigation and better search capability. Patients can now move around the site and find what they need more quickly.”
“Sixty-five per cent of our readers view our site on mobile devices and we needed to have a ‘responsive’ design where the site would format as well on a smartphone as it does on a desktop. Our new site is organized in a way that is easier to read with better illustrations that can now be enlarged with a simple click or tap.”
“The most challenging part was to organize the material in a way that patients will find useful. Our articles are now divided into four main categories: Diseases and Conditions, Treatment, Recovery, and Staying Healthy. Moving and reorganizing a large amount of information and putting it in a new content management system was a major effort and a major commitment for the American Academy of Orthopaedic Surgeons.”
“OrthoInfo is a great source of orthopaedic information for your patients. It can help patients gain information before a doctor’s visit and know what questions to ask. The information covers both surgical and non-surgical treatment. Patients can learn what to expect from surgery and recovery. Videos, animations, and online tutorials provide descriptions of surgical procedures and exercises for rehabilitation.”
Spine Surgery Complications Reduced by 36% With Lean Processes
If it works for pilots it can work for surgeons…and it does, says a new review article from Rajiv K. Sethi, M.D., an orthopedic surgeon specializing in spine surgery and health services research and executive director of Virginia Mason Neuroscience Institute’s Complex Spine Surgery and Spine Center of Excellence Programs. The article, “Using Lean Processes Improvement to Enhance Safety and Value in Orthopaedic Surgery: The Case of Spine Surgery,” was published in the November edition of the Journal of the American Academy of Orthopaedic Surgeons.
Specifically, says the research, adopting lean process improvement can transform health care by reducing variability. According to the study’s authors, “A lean organization’s goal is to provide value to the customer through a process with zero waste. The methods revolutionized manufacturing in Japan in the late 20th century, and soon after prominent U.S.-based manufacturing and service industry companies also began adopting lean processes.”
Dr. Sethi told OTW, “Strategies are needed to reduce variability and provide greater predictability with outcomes in medicine. Looking at other industries can provide this strategy.”
“Consider the aviation industry, which has embraced lean processes and a culture of safety. When flying an aircraft from New York to Seattle, there is minimal pilot variability in how the plane takes off and lands because of automation and standard, checklist-based processes that are universal among pilots of all types,” explained Dr. Sethi in the news release.
“Variability in health care creates waste and errors. Lean process improvement standardizes processes and algorithms to remove these barriers, decrease medical errors, enhance patient safety and enhance outcomes,” said Dr. Sethi. The authors’ findings suggest lean process improvement can be used in any process in which there is major variability and waste across the medical landscape to enhance cost-effectiveness and the patient experience.
“The Virginia Mason Medical Center (VMMC) in Seattle, Washington, was one of the first health care institutions to implement the lean methods.”
“Their initial work reduced the incidences of ventilator-associated pneumonia at VMMC from 34 cases with five deaths in 2002 to four cases with one death in 2004. VMMC’s usage of lean processes later extended into orthopaedic surgery and spine surgery—known as the Seattle Spine Team approach.”
“Key service providers (i.e., the spine care team) helped define the customer (i.e., the patient) value, driving them to deliver the safest and most effective complex spine surgery at the lowest cost. The processes reduced avoidable complications in complex environments with known extensive risks and the need for unplanned secondary surgeries.”
Some findings from the research include, “VMMC’s Seattle Spine Team approach significantly reduced overall complex spine surgery complication rates by 36%—from 52% to 16%. The Pittsburgh Regional Health Initiative reduced central line infections by up to 90% within one year of implementation; and, ThedaCare, a Wisconsin-based hospital group, reduced inefficiencies and waste, and created $3.3 million in institutional savings in 2004.”
“Success is a continuous improvement process,” said Dr. Sethi in the news release. “It depends on the adoption of culture that everyone is empowered to examine the process, and involved in creating and supporting the culture of change within the organization.” When successfully implemented and supported, lean process has demonstrated that it can help orthopaedic surgical teams and institutions effectively enhance safety and the value of orthopaedic care.”
Asked about any challenges or milestones, Dr. Sethi commented to OTW, “Getting engagement from multiple service lines to change their work flows and adapt to a new clinical process.”
Finally, said Dr. Sethi, “By reducing variability and eliminating waste, one can increase patient satisfaction as well as the surgeon and his/her team’s efficiency. Utilizing lean methodology is a way to achieve this. Adopt ‘standard work’ in the management of your daily clinical schedule. Set an example for your peers on reducing variability by adopting checklists, dashboards and multidisciplinary algorithms that empower team members to provide the best patient care.”
Waterless Hand Rub vs Traditional Hand Scrub: No Difference in SSI
In a first-of-a-kind study, researchers from Japan have examined the incidence of surgical site infections (SSIs) in orthopedics, comparing an alcohol-based rub and the traditional hand scrub. The study, “Waterless Hand Rub Versus Traditional Hand Scrub Methods for Preventing the Surgical Site Infection in Orthopedic Surgery,” appears in the November 15, 2017 edition of Spine.
The authors wrote, “Fourteen hundred consecutive patients who underwent orthopedic surgery (spine, joint replacement, hand, and trauma surgeries) in our hospital since April 1, 2012 were included. A total of 712 cases underwent following traditional hand scrub between April 1, 2012 and April 30, 2013 and 688 cases underwent following waterless hand rub between June 1, 2013 and April 30, 2014.”
“The SSI incidences were 1.3% (9 of 712) following the traditional protocol (2 deep and 7 superficial infections) and 1.1% (8 of 688) following the waterless protocol (all superficial infections). There were no significant differences between the two groups.”
Kentaro Iwakiri, M.D., Ph.D., with the Department of Orthopedic Surgery at Shiraniwa Hospital, Ikoma-city, Nara, Japan, told OTW, “In Japan, alcohol-based hand rub is not so common because many senior orthopedic doctors, neurosurgeons, and heart surgeons believe the traditional hand scrub is best.”
“Alcohol-based hand rub has been on the Centers for Disease Control and Prevention (CDC) guidelines since 2002. But there is no evidence saying whether the alcohol-based hand rub is safe in orthopedics. The alcohol-based hand rub is safe, cost-effective and quick.”
“In Europe or the U.S., the alcohol-based hand rub is already popular. But, there has been no evidence about the rate of SSI incidence in orthopedics between the alcohol-based rub and the traditional hand scrub. This is the first paper about it. I hope it can help to adopt for many senior surgeons who are afraid to use the alcohol-based rub.”
