And the “hits” just keep on coming for Hospital for Special Surgery (HSS)…this is the 7th year in a row that the facility has been ranked the No. 1 hospital in the country for orthopedics by U.S. News & World Report “Best Hospitals 2016-2017” survey. In addition, HSS was also recognized as a leader in rheumatology, ranking No. 2 in the nation; last year HSS was ranked No. 3.
HSS Does It Again: #1 in Ortho!

“We are proud to be recognized as the leader in orthopedics with unparalleled consistency, ” said HSS President and CEO Louis A. Shapiro, in the August 2, 2016 news release. “HSS is committed to delivering the finest care in the world to patients who want to return to doing the things they love most reliably and efficiently. Our singular focus on musculoskeletal health uniquely enables us to continuously raise the highest standards of quality, performance and value.”
“What may be most important about this unprecedented honor is its validation of the virtuous circle of focus, teamwork, quality, and value that has defined HSS for more than a century and a half, ” said Todd J. Albert, M.D., HSS surgeon-in-chief and medical director. “Everyone at HSS, from the front desk to the operating room to rehabilitation, is uniquely focused, integrated and motivated to help our patients get back to what they need and love to do most reliably and efficiently.”
“Autoimmune diseases and disorders affect nearly 50 million Americans and patients looking for a specialist want to be confident that their physician has the highest level of expertise and knowledge of the latest advances in the field, ” said Mary K. Crow, M.D., physician-in-chief and chair of Division of Rheumatology. “HSS is the largest academic medical center dedicated to bone, joint and systemic autoimmune conditions, and through pioneering research, innovation, and collaborative care we are advancing treatments and cures for patients everywhere.”
Dr. Albert told OTW, “In the last year HSS became one of the first hospitals to create a dedicated Value Management Office to ensure quality is optimized across the entire organization, and introduced new ways to make that care more accessible to more people in more places. We’re also sharing our advances in practices and protocols, such as two shortened questionnaires that significantly reduce the time it takes to collect patient-reported outcome data for hip and knee replacement surgeries (Knee injury and Osteoarthritis Outcome Score and the Hip Disability and Osteoarthritis Outcome Score). Medicare adopted these surveys for the Comprehensive Care for Joint Replacement model that launched in April 2015.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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