outcomes (range of motion,
gait, balance, muscle strength,
and pain) without an increase
in adverse events.
THKR- 3, discharged to
home, is based on the concept
that home-based rehabilitation
has been proven to result in
better pain and functional
outcomes, as well as increased
patient satisfaction, than
This measure evaluates the
percentage of patients who
are discharged to home.
Lastly, THKR- 4 evaluates
whether a general health and
functional status patient-reported outcome (PRO) tool
was completed preoperatively.
Good orthopaedic care requires
knowledge of the patient’s
history of musculoskeletal pain
and associated limitations in
daily function. Integrating PRO
data into routine orthopaedic
patient visits can provide key
information to monitor changes
in symptom severity over
time, support shared clinical
decision making, and assess
In acknowledgement of
the administrative burden
associated with PRO data
capture, The Joint Commission
will implement PRO measures
in a phased approach. During
this first phase, the process of
collecting preoperative data will
be measured. During the second
phase, pre- and postoperative
data will be evaluated with the
goal of calculating patients’
While at present these
measures are in a chart-based
manual data collection format,
The Joint Commission is testing
electronic clinical quality
measures for this measure set.
For more information about the
THKR certification program,
Questions about the
may be directed to Marilyn
Parenzan, associate project
director, department of quality
measurement, The Joint
Commission, at mparenzan@
The thoughts and opinions
expressed in this column are
solely those of Dr. Pellegrini and
do not necessarily reflect those
of The Joint Commission or the
American College of Surgeons.
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A TAP composed of experts in orthopaedic surgery, anesthesia,
rehabilitative medicine, internal medicine, physical therapy,
perioperative nursing, social work, and joint program administration
collaborated to develop these performance measures.