|The purpose of the Shoulder Arthroplasty Registry project is to develop a national Kaiser Permanente patient registry that will track patient characteristics, surgical techniques, and implant types for all shoulder arthroplasty patients, including traumatic fractures. Established in 2009, this project was developed by the orthopedic surgeons to improve the quality of care that Kaiser Permanente provides to Shoulder Arthroplasty patients. Participating regions include Northern and Southern California (Q4 2010), Colorado (Q1 2011), the Mid-Atlantic, Pacific Northwest, Ohio regions (Q2 2011) and Hawaii (Q1 2012).
The Registry will allow us to:
- Determine our revision and failure rates
- Identify and monitor recalled components
- Identify which prosthesis and surgical approaches are best for our patients
- Reduce revision rates by informing surgeons and staff about best practice
- Use registry data as a foundation for orthopedic research
Data Collection and Sources
Modeled after the Total Joint Registry, participation includes use of standardized forms (operative forms) and quarterly participation reports with goals to maintain participation above 90%. Unique to this registry, supplemental data from independent databases (i.e. Clarity, Kaiser Anesthesia and Surgery Information System (KASIS), Hospital Inpatient Management System (HIMS), Claims) dating back to 2005 are used to provide a comprehensive database.
Quality Control and Outcome Validation
To maintain data integrity, automated quarterly quality control procedures are performed using an electronic screening algorithm. ICD-9 codes are used to identify suspected complications including deep or superficial infection, venous thromboembolism, and revisions. All complications are audited via chart review by clinical content experts to determine if they meet pre-established complications criteria. Thrombotic events must occur within 90 days of implant procedure to be classified as positive. Infection complications are tracked according to the CDC/NHSN Guidelines. Deep infections must occur within one year of implant procedure. Superficial infections must occur within 30 days of implant procedure to be classified as an infection. Re-operations are tracked for the lifetime of the patient.