Title of Thesis/SIP
Date of Completion of Thesis/SIP
Scholarly Inquiry Paper (SIP)
Master of Science in Nursing (MSN)
Kimberly Langer, DNP, APRN, CNP, ACNP-BC, FNP-BC
Diane Forsyth, PhD, RN
From 2002 to 2013, there was an increase in the number of total joint replacement procedures performed as well as a rise in healthcare costs associated with such procedures. The Affordable Care Act of 2012 leveraged a shift in Medicare reimbursement from a fee-for-model (a payment model where services are paid separately) to a bundled payment method linked to quality of care. Joint replacement surgeries, specifically total knee arthroplasties (TKA), are one of the largest procedural expenditures for Medicare. To reduce costs, care associated with a TKA procedure was bundled to include all aspects of the procedure including post-operative supportive cares. Care pathways have been highly researched across the country as an effective method to reduce healthcare cost without comprising the quality of care. The goal of care pathways is to provide a seamless, structured care process that enhances decreased length of hospital stay, thus decreasing cost, while still maintaining an excellent quality of care.
Unfortunately, there is no standard care pathway for a TKA , although medical institutions may develop their own care pathway based on the requirements of Medicare reimbursement and their quality of care standards. The purpose of this scholarly inquiry paper assess for modalities of treatment for a clinical care pathway. Current literature supports the use of care pathways with a focus on structure, process and outcomes of total knee arthroplasty with the intent on reducing cost of care. Future recommendations based on the evidence supports the implementation of standardized care pathways that focuses on preoperative, intraoperative, and postoperative care for TKA procedures that meet a national standard, while maintaining quality care and taking into account the needs of each individual institution.
Pace, Katie, "Developing a Total Knee Care Pathway to Reduce Hospital Length of Stay While Maintaining Quality of Care" (2020). Nursing Masters Papers. 385.