AJRR was developed by leaders in the orthopaedic community – from renowned surgeons, to organizations involved in setting policy and manufacturers of implant components. AJRR’s Board of Directors is comprised of surgeons; medical device, payer, and hospital leaders; and patient/public representation.
In December 2015, the American Association of Hip and Knee Surgeons (AAHKS) designated us as their official Registry.
And, the hospitals, surgeons, and administrators who make up the AJRR community
Together, we are improving orthopaedic care through data!
The Joint Commission is pleased to continue to work with the American Joint Replacement Registry (AJRR) to support its multiple goals, especially the aim to establish a locus of information that can be used for quality improvement and to increase patient safety related to total hip and knee replacement surgery. The Joint Commission has served on AJRR's Public Advisory Board for a number of years and has appreciated the opportunity to be part of AJRR's efforts to increase the relevancy of the registry to patients and to providers. AJRR has exhibited a very thoughtful approach to ensuring that it builds a credible data collection infrastructure and to ensuring the usability of the registry to those focused on reducing morbidity and mortality.
The AJRR and the Ambulatory Surgery Center Association (ASCA) announce they have entered into a collaborative relationship to encourage ASCA-member ambulatory surgery centers (ASCs) to register in the AJRR. Registry participation, and the data that will be complied, will be used to validate current efforts to reduce health care costs by moving total joint replacements to Medicare's ASC-payable list and expanding the number of private payers that will reimburse ASCs for these procedures.
Each quarter, AJRR highlights individuals from participating hospitals who have championed AJRR enrollment and have demonstrated outstanding cooperation and professionalism while helping to implement the Registry into their institutions. Selections for Champions of the Quarter are made based on nominations and are voted on by AJRR staff. To nominate someone from your hospital, please contact AJRR.
Ms. Cindi Hoffner is the Total Joint Registry Registrar at Mercy Medical Center - Cedar Rapids. She ensures complete and accurate data abstraction, collection, entry, and reporting for the total joint replacement patient population, and contributes to organizational performance improvement, medical staff performance improvement, patient safety, and risk management. Ms. Hoffner began working at Mercy 13 years ago as a Data Entry Specialist for their existing total joint registry program. Because of that experience, she was able to learn from the ground up how to build the workings of a strong base for her institution's system, and therefore apply it to her work with AJRR. Ms. Hoffner has participated in numerous clinical research studies and papers with Mercy's orthopaedic surgeons.
Q: What is your favorite thing about your job?
A: Currently, I love the challenges of getting our own personalized version of the AJRR built at Mercy. We have our dedicated internal AJRR team to work on the logistics related to interfacing with our EPIC documentation system and with the Operating Room staff's documentation of critical data such as the surgical approaches and manufacturer specifications. Implementing AJRR data submission is not a one-person job. I couldn't have done this without the help of my Quality Analyst, Theresa Mahoney and my Program Coordinator, Linda Weiler. We have also had great assistance from the Clinic Manager to train all the staff and providers about the Level III patient-reported outcome measures (PROMs) data collection process within the clinic. We are all anticipating our next step of development as we move on to Level II patient risk factors, comorbidities, and complications data.
Q: Do you enjoy working with AJRR staff? If yes, why?
A: Yes, I do enjoy working with the staff at AJRR, especially Steve Hamada. He has been a great addition to the team and has helped solve several of our problems. I have a lot of respect for the whole AJRR staff! They were very helpful in our early stages of implementing the AJRR.
I am a pretty intense person and I have extreme attention to detail. I am so passionate about making sure that we have good clean data in the AJRR. We do not want to create a "garbage in and garbage out" type of system. My goal is to work with the AJRR staff, on both the large and small details to ensure our data is very valuable.
Q: How long have you been working with AJRR, and what is your role in the data submission process?
A: We started working with the AJRR in April 2016, and signed our initial contract on August 8, 2016. We began the process of submitting Level I data in November 2016. My role in the data submission process is to basically evaluate so that we "dot all of the i's and cross all of the t's." Whether that means working with our internal hospital team, or with the AJRR staff, it's imperative that we have impeccable data submitted to this national Registry. I figure if everyone around the country does this, the AJRR will grow to be the best of the best over time.
Beyond that, I have taken on the responsibility of working with our providers and staff in the hospital and clinic to get the AJRR program implemented. Our surgeons do over 1,000 total joint replacements annually. We have collected Registry data for this population for over 20 years now and I am proud to be a part of our continued commitment to tracking total joint replacement outcomes.
Q: What do you think is the most valuable aspect of Registry participation?
A: Being part of a national database is a very appealing aspect of the AJRR. I think it is great that the system has been built into the unique levels of data collection of I through III. It has been easy to articulate the various aspects of the Registry to our key stakeholders as we have rolled it out. Ultimately, it is our hope that the reported data will become valuable to all the participants as the database grows over time.
Q: What do you like to do in your free time? Do you have any hobbies or is there something about yourself that might surprise us?
A: I love volunteering. For example, I created about 72 hand-tied blankets for the kids participating in the Tanager Place program that serves kids of various ages needing assistance. It ended up being about double what I had anticipated, but it was such a rewarding experience. I am also an avid scrapbooker. I have scrapbooks dating back over the events of the past 25 years from births to graduations and many special activities in between. It's a great way to showcase the great times in our lives.
Q: If you could pass on one piece of information to a new AJRR participant, what would it be?
A: It takes a few months to get up and running with the Registry. Due diligence, and having a strong team working together are critical pieces of the AJRR puzzle.
“AJRR has taken on a monumental task, and I believe they even surprise themselves when it comes to how successful they have been. It speaks to a well-conceived plan that is being effectively executed.”
Judy Casper, Clinical Data/Research Coordinator, Midwest Orthopedic Specialty Hospital (MOSH)
“Monitoring and recording joint replacement outcomes has become essential to our internal quality improvement efforts and will soon become an expectation of the regulatory bodies, rating agencies, and payers. Our orthopaedic surgeons recognized this and encouraged us to join the AJRR, which turned out to be a surprisingly easy process. We look forward to using AJRR data to continually improve our internal processes and to demonstrate to outside agencies the quality of our joint replacement program.”
John Quinlivan, FACHE, President, Redmond Regional Health System;
Chief Executive Officer, Redmond Regional Medical Center
“The AJRR is an extremely valuable initiative for the American arthroplasty community in that, when fully functional and widely adopted, the data generated will provide timely information on national trends of implant specific utilization and outcome. At Northwestern Memorial Hospital, we hope to use AJRR institution-specific data, along with other in-house and national databanks, to benchmark our performance against national trends. Such data provides us the opportunity to increasingly crystallize our own quality initiatives. Furthermore, it is our hope that data generated from a fully functional national database may better inform health policy makers as we navigate the difficult waters of value-based decision making in arthroplasty care.”
David W. Manning, MD, Director of Arthroplasty Service at Northwestern Memorial Hospital Chicago, Ill.
“We joined the AJRR at the request of one of our physicians. He took the time to explain the potential benefit to our patients. Once we understood the value, we didn't hesitate. The process was very straight forward as far as understanding the AJRR requirements. The vast majority of the required fields are easily exported from our EMR, so the ongoing effort will be simple to maintain.”
R. Craig Lindsey, RN, MBA, MHA, CENP, Vice President of Clinical Services/Chief Nursing Officer Park Ridge Health
“By being a pilot facility for Level II and Level III data submission, I have had the ability to see firsthand the benefits of the Registry. The Registry not only provides a database for implant tracking, but will have the ability for facilities to collect quality measures throughout the continuum for benchmarking.”
Cheryl Talamo, Director of the Orthopaedic Institute
“AJRR has provided the orthopaedic community with a versatile and invaluable tool. With the option to enter data electronically, manually, or a combination of both, it is well suited for use with electronic health record systems of varying capability.”
Gwen Gratto-Cox, Clinical Research Coordinator
Southeast Georgia Health System
“AJRR’s data has been invaluable in our pursuit to better care for our joint replacement patients.”
Amanda James, CEO
Swedish Covenant Hospital
“The current medical environment in conjunction with the large increase in total joint arthroplasty in this country necessitates a national joint registry, and we are proud to have become a member of the AJRR.”
“The data collected by the AJRR will be used by ASCA and our members to support efforts to educate government and commercial payors of the safety, efficiency, and good outcomes that result when ASCs perform hip and knee replacement procedures, and will foster greater use of ASCs by patients.”