Total Shoulder Replacement: Quality Snapshot for Dr. Warner, 2011-2014

Overview

• 243 total shoulder replacements (TSA) were performed from 2011 to 2014
• 196 (80.7%) responses on satisfaction or improvement
  • 37 patients lost to follow up (did not respond to surveys) (15.2%); 10 patients were diseased or their mailing addresses were not deliverable (4.1%)

Survey Collection on TSA Quality

• Surveys were mailed out to patients who underwent TSA between 2011 and 2014
• 3 questions were asked about the quality of TSA:
  • Are you happy with the outcome of your surgery, and would you do it again given this outcome? Y/N
  • What is your Subjective Shoulder Value (SSV), 0-100% (100% as normal)?
  • Did the surgery meet, exceed, or fall short of your expectations?

Patient Satisfaction

• Patient satisfaction was defined as:
  • “Very Satisfied” with the outcome, if patients were happy with the surgery and would do it again and SSV > 80%
  • “Satisfied” with the outcome, if patients were happy with the surgery and would do it again and SSV < 80%
  • “Unhappy or worse” with the outcome, if patients were not happy with the outcome and would not do it again, or had worse function/more pain
• Overall patient satisfaction
  • 180/196 patients (92.8%) were happy with the outcomes of their surgeries
  • 153/196 patients (78.1%) were happy with their surgical outcomes and had SSV > 80% (“Very Satisfied”)
  • 14/196 patients (7.2%) were not happy with their outcomes, or had worse function/more pain

Patient Expectations

Complications: Patient Satisfaction, Resolved vs. Ongoing

• There was a total of 28 complications out of 243 operations (11.5%)
• Of the 28 complications, 3 resulted in patient dissatisfaction (3/243 = 1.2%)
  • NOTE: of 28 complications, 5 patients were deceased or had mailing addresses not deliverable, and 6 were lost to follow up (did not complete surveys)

Complication: Results of Nerve Injuries, Readmission and Reoperation

• 8 patients were re-admitted to the hospital after surgery and subsequently re-operated on (8/243 = 3.3%)
  • 5 resolved, 2 ongoing, 1 lost to follow up
• 3 patients became infected after TSA (3/243 = 1.2%)
  • 2 resolved, 1 ongoing
• 10 patients had nerve issues after TSA (10/243 = 4.1%)
  • 6 resolved, 3 ongoing, 1 lost to follow up