Highline Medical Center has been recognized by the Premier healthcare alliance as a top performer nationwide in hip and knee replacement procedures.

One of only six hospitals to receive the 2007 Premier Award for Quality for excellence in the care of patients in this category, the medical center has one of the lowest complication rates for patients undergoing joint replacement surgery. The winners were selected from a pool of 400 hospitals.

Highline also was recognized for its high compliance rates with national patient safety measures, and for efficiency in the allocation of the hospital's surgical resources for these procedures.

The largest healthcare alliance in the United States, Premier is dedicated to improving patient outcomes while safely reducing the cost of care.

Premier "looked at the [post-joint replacement] complication rate, readmission rate and cost," said Highline CEO Mark Benedum. "Based on that, our outcomes were number four in the country."

The award is a tribute to the teamwork of our physicians and staff, Benedum said.

"With hip and knee surgery, it starts with the orthopedic surgeons. They work closely with the anesthesiologists ... and collaborate with the nurses....

"Then we have a physical rehabilitation program that's part of our Specialty Campus. It's a real advantage to our patients because all the services they need are under one umbrella" ---

Highline orthopedic surgeon John Lombardi, M.D., described the award as "a great way to see how Highline compares nationally with patients outcomes.

"Our top priority is that our patients recover quickly and do well."

The achievement of these results was reflected through the award process, which "was a very intensive evaluation of what goes on at Highline," Lombardi said.

"What we have seen through this award is that we have minimized the risks [of total joint replacement] to our patients at Highline to the degree that we were one of six [hospitals] in the nation to achieve this award."

But while awards are great, Lombardi emphasized, "what's important to the surgeon, surgical staff and the hospital staff is that our patients do well."

"This award objectively reflects the quality of patient care that ... we strive to achieve."

The Premier Award also measures efficiency of care, and Highline now saves an average of three days per patient stay after total joint replacement surgery.

One way this is accomplished is with smaller incisions, which reduce trauma to the joint, he said.

Another is putting patients who have had knee replacement surgery on a motion machine to get the new joint moving while they are still in the recovery room.

Beyond the replacement procedure, coordinating patient care with physical therapists and the case management team for discharge planning also improves the efficiency of care, Lombardi added.

"The award is for a combination of measures, including low complication rates," said Scott Kennard, M.D., chairman of Anesthesiology Department and operating room medical director at Highline.

The outcomes measured by Premier require "that we do our job consistently well, use our [hospital] resources well and work together well as a team."

The result, Kennard said, is that "our patients are happy with the service they receive, the experience they go through."

In preparing patients for hip or knee replacement surgery, "We explain carefully what's going to happen and why we suggest a specific plan of care."

"Most joint replacement patients no longer are given general anesthesia. Instead, they receive a spinal block combined with sedation, followed by a nerve block for post-operative pain relief. Regional anesthesia has been shown to lessen the amount of blood loss and decreases the chance of complications like blood clots," Kennard continued.

Another "big push" in joint replacement is to minimize the risk of infection "with the administration of antibiotics in the 'golden hour' before surgery starts. "With that process, we are achieving close to a 100 percent success rate."

Stephanie Alexander, senior vice president and general manager of Premier Healthcare Informatics, said, "Hospitals that win the Premier Award for Quality deliver the highest quality of patient care in a cost-effective way ... by using best practices and evidence-based decision- making."

Kennard, a anesthesiologist at Providence Medical Center in Seattle for 18 years before coming to Highline, also observed, "Highline is finally being recognized for what we do." "It's nice working with a smaller facility that has the capability of being nationally recognized," he said.

"The Burien community has a jewel in its midst. This award really shows that Highline provides medical care that is as good if not better than at some larger hospitals."