Expanding Orthopedic Clinical Protocols Across the Pond

Client: A renowned U.S.-based standalone academic medical center focused exclusively on musculoskeletal conditions and performing over 40,000 surgical procedures annually. Founded in 1863, it is the oldest orthopedic hospital in the United States and has been ranked #1 in orthopedics by U.S. News & World Report for 16 consecutive years.

Distinctive Factor: Advising an international government-sponsored healthcare system.

Situation: The U.S. orthopedic hospital wanted to expand its services overseas to the United Kingdom, where socialized medicine had resulted in long waits for care and where surgical patients were typically ten years older than in the U.S. Additionally, infection and comorbidity rates were higher, resulting in hospital readmissions and follow up surgeries. The U.S. hospital believed that their clinical protocols for orthopedic surgeries could provide a higher quality of care, shorter lengths of stay, and improved patient satisfaction.

Engagement: The hospital engaged DRESKIN founder Ron Dreskin to evaluate the potential benefits of expanding its surgical protocols and services to the United Kingdom’s National Health Service (NHS), which serves England, Scotland, Wales, and Northern Ireland. Dreskin traveled to the UK and met with representatives from all NHS hospitals providing orthopedic surgery.

Beginning with hip procedures, Dreskin collected and analyzed clinical outcome data from NHS hospitals and compared those results to the U.S. hospital’s outcomes, focusing on infection rates, complications, readmissions, and patient age. This in-depth statistical review and cost-benefit analysis identified meaningful opportunities to improve care for NHS patients. Because the NHS operates under a nationalized healthcare system, not all their hospitals offer orthopedic surgery, creating capacity constraints.

Dreskin’s analysis demonstrated how adopting the U.S. hospital’s protocols could introduce efficiencies, shorten hospital stays, and expand surgical capacity, thus improving quality of care.

Dreskin then engaged with U.K. government healthcare representatives to educate them regarding the benefits and opportunities of implementing U.S. hospital’s protocols. The project concluded with an agreement between both parties to introduce U.S. protocols across the NHS.

Outcome:

• The U.S. hospital opened a new revenue stream and began introducing additional protocols for many other orthopedic services.
• NHS significantly improved their standards of care for orthopedic services.
• Reduced average length of stay from eight days to two, resulting in over 50% cost savings for the NHS.
• Reduced average patient age from 73 years old to 68, increasing procedure volume by 30%.
• Reduced healthcare-associated infection rates from 4% of patients to 1.8%.