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AAOS Now

Published 12/1/2014

AAOS Hosts Orthopaedic Quality Institute

Each year, the AAOS hosts the Orthopaedic Quality Institute (OQI) in Washington, D.C. The OQI brings together members of the orthopaedic community and other stakeholders—including payers, purchasers, healthcare policymakers, industry representatives, and patient advocacy groups—to discuss strategies for improving quality and measuring outcomes in musculoskeletal care.

Increasingly, both the way and the environment in which physicians deliver and get paid for healthcare services are changing. At the federal government level, debates over healthcare costs and quality are constant. Policymakers and other stakeholders are continually seeking to define appropriate methodologies to accurately measure quality. For example, the latest efforts to introduce legislation that would repeal and replace the Sustainable Growth Rate (SGR) included language to reward use of alternative payment models and encourage adherence to appropriate use criteria.

The 2014 OQI (Nov. 20–21) focused on “Tools for Improving Quality and Measuring Performance” and was chaired by Kevin J. Bozic, MD, MBA, and Thomas C. Barber, MD. Among the goals of the 2014 OQI were developing recommendations to guide the AAOS outcomes measurement strategy and strengthening external partnerships with data collection and reporting agencies.

“It is important for the AAOS to engage in defining quality and providing the tools necessary for our members to measure clinically meaningful outcomes,” said Dr. Bozic. “By establishing and maintaining partnerships with data collection and reporting agencies, we hope to build a performance measurement strategy to ensure that orthopaedic surgeons are on the leading edge of performance improvement and value-based payment and reporting programs.”

The AAOS believes it is crucial that orthopaedic surgeons retain a leadership position in defining quality of orthopaedic care. Recent quality initiatives undertaken by AAOS include clinical practice guidelines (CPGs), appropriate use criteria (AUC), and performance measures. CPGs serve as the evidence base for various procedures and treatment protocols. AUC topics are derived from CPGs and address when these procedures might be appropriate for certain patients, given the nuances of everyday clinical practice.

Dr. Bozic, in introducing the session, highlighted this process, its importance, and the rationale of the OQI. AAOS President Frederick M. Azar, MD, also spoke on the continued AAOS commitment to quality.

Joe V. Selby, MD, MPH, executive director, Patient Centered Outcomes Research Institute (PCORI), gave the keynote address. PCORI is a nonprofit, nongovernmental organization located in Washington, D.C., that seeks to improve the quality and relevance of evidence available to help patients, caregivers, clinicians, employers, insurers, and policymakers make informed health decisions. 

Breakout sessions facilitated discussions to help formulate the Academy’s strategic plan for clinical outcomes measurement. Delving deeper into specific questions that built upon the presentations, breakout session participants answered questions on outcomes measurements in three different practice settings: ambulatory surgical care, office-based care, and inpatient surgical care.

Participants discussed recommendations and rationales for what orthopaedic conditions should be measured. They also provided suggestions on data sources or tools that could be used for outcomes measurement and identified potential barriers to outcomes data collection that might exist in different settings. Afterward, they helped develop a series of specific outcomes to guide AAOS quality efforts going forward.

Additional coverage of the 2014 OQI will be included in upcoming issues of both Advocacy Now and AAOS Now.