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Patient-Reported Outcomes of Shoulder Surgery in a Community Orthopedic Practice: A 5-Year Quality Improvement
Orthopedics
|July 1, 2020
Summary
This quality improvement study found that while most shoulder surgery patients improve, those with concomitant biceps tenodesis or distal clavicle excision experienced worse outcomes. Patient-reported outcomes are key for value-based care.
Area of Science:
- Orthopedics
- Quality Improvement
- Patient-Reported Outcomes
Background:
- US healthcare is shifting towards value-based systems.
- Patient-reported outcomes (PROs) are crucial for evaluating care value.
- Quality improvement projects in private practice can assess care delivery.
Purpose of the Study:
- To evaluate shoulder surgery care processes and outcomes in a private practice setting.
- To compare patient-reported outcomes against established standards.
- To identify factors influencing functional outcomes after shoulder surgery.
Main Methods:
- A 5-year quality improvement project involving 1304 shoulder surgery patients.
- Collected QuickDASH questionnaires at 4 time points.
- Analyzed functional scores based on procedure, concomitant procedures, workers' compensation status, and sex.
Main Results:
- Patients undergoing rotator cuff repair with biceps tenodesis or distal clavicle excision showed worse preoperative and postoperative scores.
- Male shoulder arthroplasty patients reported worse preoperative function.
- Non-workers' compensation patients had better 1-year functional scores, while workers' compensation patients were younger.
Conclusions:
- Quality outcome studies are feasible and beneficial in private practice settings.
- Identifying specific patient groups with poorer outcomes can guide practice improvements.
- PROs provide valuable insights for enhancing shoulder surgery care delivery and value.
