Choosing the right doctor and hospital

Finding the right hospital

The quality of the health care you receive depends on many things besides the skill of your surgeon. Many health care providers at a hospital will be directly involved in your care before, during, and after surgery.

The work of all hospital staff 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

There are many things a hospital can offer 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 a floor or unit that is used only for joint-replacement surgeries
• Operating rooms that are used only for orthopedic surgery and joint replacement
• Specific guidelines so that everyone who has knee-replacement surgery receives the type of care they need
• Enough nurses

It can also be helpful to know how many knee replacements have been done at the hospital you have chosen or are considering for your surgery. 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 of them your hospital has already done.

High-quality measures

Hospitals are now being asked to report events called "quality measures." These measures are reports of different things that affect patient care. Some common quality measures are the number of:

• Patient injuries, such as falls
• Patients who receive the wrong medicine or the wrong dosage of a medicine
• Complications, such as infections, blood clots, and pressure ulcers (bedsores)

Hospitals receive scores for their quality. These scores can give you an idea of how your hospital compares to other hospitals.

Find out if your hospital is accredited by The Joint Commission (a 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 consumer 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 or states work with businesses, doctors, and hospitals to gather information about quality. You can look for this information online.
• The government gathers and reports information about hospitals. You can find this information online at www.hospitalcompare.hhs.gov.
• Your health insurance company may rate the joint-replacement programs at different hospitals. Ask your insurance company if it does this type of rating.

Finding the right doctor

Ways to check a doctor's skills, knowledge, and quality of care

Getting a recommendation of doctors who perform knee-replacement surgeries from friends or your health care provider is important. But there are other ways to check on the skills, knowledge, and quality of care that different doctors provide. You can learn more about doctors and the quality of their care from:

• Websites
• Consumer groups
• Other organizations

While these sources of information are often helpful, find out if they are reliable before using them to 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 subspecialty. 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 tests their knowledge, skills, and experience in their specialty. Orthopedic surgeons are certified by the American Board of Orthopedic Surgery.

Is your doctor experienced?

Knee-replacement surgeries are very technical. Ask your surgeon how many knee-replacement surgeries he or she has done. Make sure your surgeon has received special training in any newer procedures, if that is what you plan to have. Some of the 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
• Continuing pain
• Problems with wounds, such as poor healing or infection