The Journal of Bone & Joint Surgery. 93(Supplement_3):81–88, DECEMBER 21ST, 2011

DOI: 10.2106/JBJS.K.01010

,  

PMID: 22262430

Issn Print: 0021-9355

Publication Date: December 21st, 2011


Share this on facebook   Share this on Twitter   Share this on LinkedIn   Email this article  



Print

Outlier Analysis in Orthopaedics: Use of CUSUMThe Scottish Arthroplasty Project Shouldering the Burden of Improvement

Gavin Macpherson;Ivan Brenkel;Rik Smith;Colin Howie;

+ Author Information


    loading  Checking for direct PDF access through Ovid

Abstract

National joint registries have become well established across the world. Most registries track implant survival so that poorly performing implants can be removed from the market. The Scottish Arthroplasty Project was established in 1999 with the aim of encouraging continual improvement in the quality of care provided to joint replacement patients in Scotland. This aim has been achieved by using statistics to engage surgeons in the process of audit. We monitor easily identifiable end points of public concern and inform surgeons if they breach our statistical limits and become “outliers.” Outlier status is often associated with poor implants, and our methods are therefore applicable for indirect implant surveillance. The present report describes the evolution of our statistical methodology, the processes that we use to promote positive changes in practice, and the improvements in patient outcomes that we have achieved. Failure need not be fatal, but failure to change almost always is. We describe the journey of both the Scottish Arthroplasty Project and the orthopaedic surgeons of Scotland to this realization.

Related Topics

    Related Articles

        loading  Loading Related Articles