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Development of Diagnostic Quality Metrics for Prosthetic Joint Infection.

Andy O Miller, Alberto V Carli, Amy Chin

    Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
    |January 2, 2024
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    Developing quality measures for prosthetic joint infection (PJI) diagnosis is crucial. A panel identified five valid measures to improve PJI diagnosis timeliness and accuracy, addressing critical care gaps.

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    Area of Science:

    • Orthopedics
    • Infectious Diseases
    • Healthcare Quality Improvement

    Background:

    • Established guidelines exist for prosthetic joint infection (PJI) diagnosis.
    • However, the diagnostic quality and associated care gaps remain poorly understood.
    • Improving PJI diagnosis is vital to reduce patient morbidity, mortality, and economic impact.

    Purpose of the Study:

    • To develop valid clinical quality measures for PJI diagnosis.
    • To enhance the timeliness and accuracy of PJI diagnosis.
    • To identify and address quality gaps in PJI diagnostic processes.

    Main Methods:

    • A multidisciplinary national panel of nine PJI experts was convened.
    • Experts included orthopedic surgeons, infectious disease specialists, and an emergency medicine physician.
    • The RAND-UCLA appropriateness method was modified to rate proposed quality measures.

    Main Results:

    • Fifty-seven permutations of six proposed quality measures were evaluated.
    • The panel identified high-risk populations requiring specific care processes.
    • Five of the proposed clinical quality measures were rated as valid by the expert panel.

    Conclusions:

    • Novel clinical quality measures for PJI diagnosis have been developed.
    • These measures can offer insights into existing diagnostic care gaps.
    • Implementation of these measures may improve PJI diagnostic quality and patient outcomes.