Measuring the Quality of Orthopedic Care at Cedars-Sinai

Cedars-Sinai Orthopaedics continually monitors the care it provides to patients. Several factors are measured:

  • Total volume of procedures. Studies suggest that for many surgical procedures, hospitals that perform high volumes have better quality outcomes, i.e., lower short-term and long-term mortality and morbidity. Volume is an indicator of experience, which influences outcomes in multiple ways. In addition to the experience of surgeons in performing specific procedures, high-volume hospitals may institute specific care processes that improve outcomes and have the infrastructure dedicated to particular clinical specialties, including related technology and intensive care personnel. Commitment to quality standards throughout the institution is also an important determinant of better outcomes.1,2 In addition, outcomes for high-risk procedures have been shown to be better when performed by more highly-trained surgeons than by general surgeons.3
  • Average length of stay. This refers to the average number of days a patient stays at Cedars-Sinai after being admitted. The goal is to ensure that all patients are appropriately treated in the hospital for their respective conditions and are not hospitalized longer than they need to be.
  • Surgical Site Infections. A surgical site infection is an infection that occurs after surgery, in the part of the body where the surgery was performed. Many such infections involve the skin only, but some are more serious and in tissues under the skin or in an organ. These are called deep incisional and organ/space surgical site infections. We measure our performance by tracking the observed vs. expected rate of infection, as calculated by the California Department of Public Health and the Centers for Disease Control and Prevention's National Healthcare Safety Network. To learn more and to view Cedars-Sinai performance for hip and knee replacement surgeries, click the links below.
  • Preventing surgical site infections after hip replacement surgery
  • Preventing surgical site infections after knee replacement surgery

During 2016, over 5,000 inpatient and outpatient procedures were performed at the Cedars-Sinai Orthopaedics. Volumes by area of the body are listed below. Additional information is provided below for hip and knee replacements, as this is the most commonly performed inpatient procedure.

Cedars-Sinai Orthopaedics, 2016 Outpatient Procedures Total Procedures
Foot/ankle procedures 883
Arm procedures 436
Leg procedures, excluding knees 272
Wrist /Hand procedures 241
Hip/knee procedures 220
Shoulder procedures 203

Inpatient Hip/Knee Replacements, 2016 Cedars-Sinai Expected (based on patients with similar clinical characteristics)
Total procedures 1,779 not applicable
Average length of stay 2.7 days 2.8 days

Source: The inpatient data shown above comes from the University HealthSystem Consortium (UHC), an alliance of more than 300 of the nation’s nonprofit academic medical centers and their affiliated hospitals. The majority of these facilities participate in UHC's Clinical DataBase/Resource Manager. This data reflects patients discharged during 2016. Data was accessed on Feb. 25, 2017. The foot/ankle numbers came from CSMC internal data.

1Bach PB, Ann Intern Med 2009; 150(10):729-30
2Greene FL, Ann Surg Oncol 2007; 15:14-15
3Kozower BD et al, Ann Thorac Surg 2008; 86:1405-08