Leading the Way in Standardization in Orthopedics:

The CORE Institute’s Commitment to Quality through Evidence-Based Healthcare

The CORE Institute remains at the forefront of promoting and adhering to evidence-based standardized practices in orthopedics. Since the Institute’s inception, this commitment has been driven by our consistent focus on delivering the highest quality care to our patients, supported by strong evidence that standardization enhances outcomes, safety, efficiency, and the patient experience.

Improving Standards Through Clinical Data

Standardization in orthopedics involves physician agreement and adoption of evidence-based protocols and guidelines to ensure consistent and predictable results.

We have championed this approach, as it reduces unjustified variability in care. We believe, and the literature shows, that elimination of unjustified variability is crucial for maintaining high standards across different conditions, procedures and patient populations.

This emphasis on standardization and consistency enhances our ability to track clinical data and outcomes, which we use for continuous feedback and improvement.

Our Approach to Healthcare

Key Features of Our Standardization

Hundreds of studies and peer reviewed publications, some of them authored by physicians at The CORE Institute, have demonstrated the extensive benefits of standardization principles in orthopedics.1-13 For example, implementing standardized surgical protocols and techniques has been shown to significantly reduce complications, shorten hospital stays and recovery times, improve outcomes, and enhance the patient experience. 

Additional proven benefits of standardization include improved communication with patients and care teams, reduced healthcare costs (without compromising clinical outcomes), and an enhanced ability to convert savings into better patient care and value to our healthcare system.

Evidence-Based Protocols

Our physicians adhere to rigorously developed protocols that ensure consistent and predictable outcomes for every patient.

Clinical Excellence

We prioritize clinical quality improvement, leveraging the latest research to refine our practices continuously.

Innovative Technology

Investments in cutting-edge technology enhance our ability to track outcomes and improve patient care.

Patient-Centric Care

Our approach focuses on the individual needs of each patient, ensuring personalized treatment plans.

Collaborative Teams

Our multidisciplinary teams work together to provide comprehensive care, fostering communication and efficiency.

Global Expertise

We attract top clinicians worldwide who share our commitment to standardization and quality in healthcare.

Evidenced-Based Leadership

The CORE Institute has championed standardization and clinical quality improvement efforts in a variety of ways across the organization. This process has been at the center of The CORE Institute’s history and development. Committees of designated physicians meet regularly to review the latest clinical evidence to initiate and refine standards, protocols, and guidelines across clinical and operational processes. These include The CORE Institute’s standardized formulary for vendors, implants, as well as other products, and processes.

New standardization opportunities are identified through The CORE Institute’s quality assurance process, which is designed to monitor and improve the quality of care provided within the organization. The CORE Institute deploys a committee and workgroup process to review evidence-based clinical indications, product safety and efficacy profiles, for all new products. This process is overseen by the Chief Medical Officer, who works with the various leaders in the organization, including specialty-specific leadership.

Our Beliefs & Principals

The CORE Institute has invested heavily in new technologies, including clinical data tracking systems, and clinical quality teams to enhance the ability of its care teams to constantly improve outcomes and minimize unwarranted variations in care. These deliberate processes adopted across the organization, also help care teams to be accountable to efforts that enhance clinical excellence.

Widely known and promoted as a foundational principle of The CORE Institute practice model, our explicit focus on evidence-based clinical standardization remains a prominent feature.  It helps us attract top clinicians from around the world, who share our commitment to clinical standards and quality. Physicians who believe that other products or processes might help improve the quality of care we offer are invited to provide evidence in support of their beliefs, and that evidence is carefully evaluated. Also, physicians remain free to vary their treatment plans based on their evidence-based assessments of the needs of each patient. 

The CORE Institute’s leadership in promoting clinical standardization is reflected by our physician’s numerous contributions to the scientific literature on this topic, lectures and physician education.13-17  We believe that standardization, when grounded in robust evidence and published research, enhances patient safety, promotes consistency in care, and fosters continuous improvement. By committing to these principles, we not only uphold the highest standards in orthopedic care, but also ensure that every patient receives the best possible outcomes, supported by the most current evidence.

References

  1. Barbieri A, Vanhaecht K, Van Herck P, Sermeus W, Faggiano F, Marchisio S, Panella M. Effects of clinical pathways in the joint replacement: a meta-analysis. BMC Med. 2009 Jul 1;7:32. doi: 10.1186/1741-7015-7-32. PMID: 19570193.
  2. Bozic KJ, Maselli J, Pekow PS, Lindenauer PK, Vail TP, Auerbach AD. The influence of procedure volumes and standardization of care on quality and efficiency in total joint replacement surgery. J Bone Joint Surg Am. 2010 Nov 17;92(16):2643-52. doi: 10.2106/JBJS.I.01477. PMID: 21084575.
  3. Koenig KM, Bozic KJ. Orthopaedic Healthcare Worldwide: The Role of Standardization in Improving Outcomes. Clin Orthop Relat Res. 2015 Nov;473(11):3360-3. doi: 10.1007/s11999-015-4492-6. Epub 2015 Aug 7. PMID: 26250138.
  4. Badge HM, Churches T, Naylor JM, Xuan W, Armstrong E, Gray L, Fletcher J, Gosbell I, Lin C, Harris IA. Non-compliance with clinical guidelines increases the risk of complications after primary total hip and knee joint replacement surgery. PLoS One. 2021 Nov 18;16(11):e0260146. doi: 10.1371/journal.pone.0260146. PMID: 34793555.
  5. Raveglia, Orlandi, Rimessi, Minervini, Cioffi, De Simone, Guttadauro and Scarci, Standardization of Procedures to Contain Cost and Reduce Variability of Care After the Pandemic Front Surg. 2021; 8: 695341 Epub online 2021 Jun 24. doi: 10.3389/fsurg.2021.695341 PMID: 34250010.
  6. NEJM Catalyst, Lessons from Health Care Leaders: Rethinking and Reinvesting in Patient Safety Commentary from quality and safety leaders on the persistence of adverse events in care delivery — and where health care organizations should go from here. Epub online 2023 April 4.
  7. Welch, M, Merkley, K, Standardizing Excellence: 5 Pillars for Reducing Unwarranted Care Variation; https://www.healthcatalyst.com/insights/standardizing-excellence-five-pillars-reducing-unwarranted-care-variation. Epub online 2024.
  8. Experian Health, How data standardization can improve patient outcomes, https://www.experian.com/blogs/healthcare/data-standardization-can-improve-patient-outcomes/#:~:text=Standardizing%20data%20collection%20and%20ensuring,when%20new%20data%20is%20added. Epub 2021 Aug 25.
  9. Bernstein DN, Hanna P, Merchan N, Rodriguez EK, Appleton PT, Kwon JY, Wixted JJ. Lack of Surgeon Standardization on Implant Selection in Ankle Fracture Fixation May Increase Costs and Decrease Contribution Margin. Foot Ankle Spec. 2023 Apr;16(2):129-134. doi: 10.1177/19386400211009357. Epub 2021 Jun 18. PMID: 34142591.
  10. Gioe TJ, Sharma A, Tatman P, Mehle S. Do “premium” joint implants add value?: analysis of high cost joint implants in a community registry. Clin Orthop Relat Res. 2011 Jan;469(1):48-54. doi: 10.1007/s11999-010-1436-z. PMID: 20568026.
  11. Jevsevar DS, Bozic KJ. Orthopaedic Healthcare Worldwide: Using Clinical Practice Guidelines in Clinical Decision Making. Clin Orthop Relat Res. 2015 Sep;473(9):2762-4. doi: 10.1007/s11999-015-4336-4. Epub 2015 May 16. PMID: 25981712.
  12. Shah AS, Waters PM, Bozic KJ. Orthopaedic healthcare worldwide: standardized clinical assessment and management plans: an adjunct to clinical practice guidelines. Clin Orthop Relat Res. 2015 Jun;473(6):1868-72. doi: 10.1007/s11999-014-4060-5. Epub 2014 Nov 25. PMID: 25421956.
  13. Scalise J, Dunbar M, Jacofsky D. Evolving Beyond Craft Surgery Is Both Inevitable and Essential. J Knee Surg. 2017 Jan;30(1):3-6. doi: 10.1055/s-0036-1593368. Epub 2016 Sep 29. PMID: 27685768.
  14. Jacofsky DJ. The myths of ‘big data’ in health care. Bone Joint J. 2017 Dec;99-B(12):1571-1576. doi: 10.1302/0301-620X.99B12.BJJ-2017-0939. PMID: 29212678.
  15. Loftus T, Agee C, Jaffe R, Tao J, Jacofsky DJ. A simplified pathway for total knee arthroplasty improves outcomes. J Knee Surg. 2014 Jun;27(3):221-8. doi: 10.1055/s-0033-1360657. Epub 2013 Nov 14. PMID: 24234550.
  16. Khan M, Della Valle CJ, Jacofsky DJ, Meneghini RM, Haddad FS. Early postoperative complications after total hip arthroplasty: current strategies for prevention and treatment. Instr Course Lect. 2015;64:337-46. PMID: 25745918.
  17. Loftus T, Dahl D, OHare B, Power K, Toledo-Katsenes Y, Hutchison R, Jacofsky D, Harder K. Implementing a standardized safe surgery program reduces serious reportable events. J Am Coll Surg. 2015 Jan;220(1):12-17.e3. doi: 10.1016/j.jamcolls

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