Choosing the right doctor and hospital
Finding the right hospital
Quality health care depends on many things besides how skilled your surgeon is. Many health care providers at a hospital will be directly involved in your care before, during, and after surgery.
The work of all staff in a hospital affects how well the hospital functions. This affects your safety and the quality of the care you will receive there.
Choosing the best hospital for your knee replacement
A hospital can offer many things to improve the quality of care you receive when you have a knee replacement. For example, find out if your hospital has:
- A floor or unit that does only orthopedic surgery or that is used only for joint-replacement surgeries.
- Operating rooms that are used only for orthopedic surgery and joint replacement.
- Guidelines or pathways for care that help ensure that everyone who has knee-replacement surgery receive the type of care they need.
- Enough nurses.
Also find out how many knee replacements have been done at the hospital. Patients who have surgery at hospitals that do more of the same type of procedure often do better.
If you are having one of the newer knee-replacement techniques, find out how many your hospital has already done.
Hospitals are asked to report events called "quality measures." These are reports of things that affect patient care. Common measures include the number of:
- Patient injuries, such as falls
- Patients who receive the wrong medicine or the wrong dosage of a medicine
- Patients who didn't receive antibiotics before surgery
- Complications, such as infections, blood clots, and bedsores (pressure ulcers)
Hospitals receive scores for their quality. These scores can give you an idea of how your hospital compares with others.
Find out if your hospital is accredited by The Joint Commission. This is a federal nonprofit organization that seeks to improve the quality and safety of health care.
Also see if your hospital is rated highly by state agencies or other groups. Some places to look for hospital ratings are:
- State reports. Some states require hospitals to report certain information to them, and some publish reports that compare hospitals in the state.
- Nonprofit groups in some areas work with businesses, doctors, and hospitals to gather information about quality. You can look for this information online at www.healthgrades.com.
- The federal government gathers and reports information about hospitals. You can find this information online at www.medicare.gov/hospitalcompare/search.html.
- Your health insurance company may rate the joint-replacement programs at different hospitals. Ask your insurance company if it does this.
Finding the right doctor
Ways to check a doctor's skills, knowledge, and quality of care
You may have gotten the name of a doctor who does knee-replacement surgery from a friend, a website, or your primary care provider.
Recommendations from friends or your provider are important. But there are other ways to check a doctor's skills, knowledge, and quality of care. You can learn more about doctors and the quality of their care from:
- Consumer groups
- Other organizations
Just be sure to find out if a source is reliable before using it to help make a decision.
Is your doctor board-certified?
"Board-certified" means that a doctor has completed a training program in a specialty. Orthopedics is a sub-specialty. Doctors receive 5 years (sometimes more) of extra training in their specialty after they finish medical school.
To become board-certified, doctors must pass an exam (called a "board") that assesses their knowledge, skills, and experience in their specialty. Orthopedic surgeons are certified by the American Board of Orthopaedic Surgery.
Is your doctor experienced?
Knee-replacement surgeries are very technical. Ask your surgeon how many knee-replacement surgeries they have done. Make sure your surgeon has received special training in any newer procedures, if that is what you plan to have. Some newer techniques require special skills.
To perform any surgery at a hospital, a surgeon must be credentialed. This means that the hospital has made sure the surgeon is trained and has the experience needed to perform the surgery.
You may also ask your doctor how often his or her patients have these problems after surgery:
- A second knee replacement after the first one
- Ongoing pain
- Problems with wounds, such as poor healing or infection