Our expert answers 3 Questions
As Co-Director of the Michigan Arthroplasty Registry Quality Collaborative Initiative (MARCQI), I am currently thinking about how operations research and biomechanics can be incorporated into orthopaedic quality improvement. On the operations research side, I am working on incorporating decision analysis into the analysis of observational data for use in quality improvement. I am particularly interested in applying this to post-marketing surveillance of arthroplasty implants. Biomechanics, which is the application of engineering mechanics to biological systems, plays a role because prosthetic component alignment partially determines the success of total joint replacement surgery. I am working to develop image analysis methods so that surgeon performance, as measured by prosthetic component alignment, can be integrated into a decision-theoretic post-marketing surveillance framework.
My professional career has focused on the application of operations research methods to problems in biomechanics. Operations research brings a beautiful set of mathematical tools to bear on problems, and biomechanics integrates them with practical problems of musculoskeletal disorder prevention, treatment, and rehabilitation. The experience of Co-Directing MARCQI has shown me that these tools are directly applicable to health care quality improvement.
Hip and knee arthroplasty utilization continues to grow rapidly in the United States. MARCQI is demonstrating that quality improvement can improve quality of care and reduce cost concurrently. Continued application of the collaborative quality improvement model embodied by MARCQI will improve care in Michigan, and publishing results from MARCQI will help spread this model beyond Michigan. The analysis methodologies being developed will also assist other arthroplasty QI registries around the world, leading to improved care for a very large number of patients.