Mount Sinai West is announcing that it has earned The Joint Commission on the Accreditation of Healthcare Organizations’ [JCAHO] Gold Seal of Approval for Advanced Certification for Total Hip and Total Knee Replacement, making it one of the few hospitals in New York City and New York State to receive the prestigious certification for an orthopedic program. According to the January 23, 2017 news release, there are 25 other orthopedic programs in the United States, including the program at Mount Sinai Beth Israel, which have been granted this top honor for Total Hip and Total Knee Replacement.
Mount Sinai West: JCAHO Seal for Total Hips, Knees

“This certificate shows that Mount Sinai West provides an exceedingly high level of care in every parameter of joint replacement when it comes to positive outcomes, low complication rates, and the high patient satisfaction, ” said Michael Bronson, M.D., chair, Department of Orthopaedics, Mount Sinai West, in the news release. Dr. Bronson, also chief, Joint Replacement Surgery, and associate professor, Icahn School of Medicine at Mount Sinai, added, “The Advanced Certification sends a message to the community that if you’re considering having joint replacement surgery, you can be assured you will get superlative care at Mount Sinai West.”
As indicated in the news release, “The Department of Orthopaedic Surgery at Mount Sinai West underwent a rigorous, two-day, on-site survey in November 2016, in which a reviewer from The Joint Commission conducted an exhaustive analysis of care provided to patients requiring total hip and knee replacements. They examined all aspects, including pre-operative evaluation, the surgery itself, and the patient’s recovery in the hospital following the procedure. The Joint Commission evaluated specifics involving patient education leading up to the procedure, the safety and success of the surgery, and that patients can function independently at home in the weeks after hospital discharge.”
“This achievement reflects the hard work and expertise of our administrative and clinical staff at Mount Sinai West and I’m grateful for their efforts that contributed to this honor, ” said Leesa Galatz, M.D., System Chair, Orthopaedics, Mount Sinai Health System, and Mount Sinai Professor, Leni and Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai.
“Mount Sinai West is proud of our exceptional joint replacement service and fabulous work of our orthopaedic surgeons and pleased that the joint commission recognizes our superior care with this prestigious designation, ” said Evan Flatow, M.D., President, Mount Sinai West.
Dr. Bronson told OTW, “What stands out about joint replacement at Mount Sinai West is the comprehensive care our patients receive which starts at the first office visit, continues through our joint class where patients speak to anesthesia, physical therapy, social work, our PA [physician assistant] group and further continues throughout the hospital stay where they benefit from a meticulous care pathway which has been worked out to provide what we see as the gold standard of care, and then through their discharge with home therapy and physician follow-up.”
“The process for successful certification by JCAHO is rigorous and mandates over a year of preparation and several days of onsite evaluation.”

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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