title: Comprehensive Care for Joint Replacement (CJR) Bundle Expense in Perioperative Pain Management.
abstract: The implementaion of the Comprehensive Care for Joint Replacement (CJR) model has necessitated value-focused care for a 90-day period. Pain management in joint arthroplasty therefore represents a focused opportunity to achieve lasting change in the delivery of care. To be successful, orthopedic surgeons must integrate approaches that take into account administration route and therapy duration, and various combinations thereof, to achieve improved longer term outcomes for joint arthroplasty patients. In addition, pain management choices must be based on value and not on simple costs, as patient satisfaction scores affect CJR repayments. While the postdischarge time period poses the highest risk, improved collaboration with post-acute care providers, such as hospitalists, pharmacists, and rehabilitation facilities will be crucial to addressing patient comorbidities and ensuring optimal outcomes post-surgery. Furthermore, multimodal pain management strategies associated with optimal pain control and shorter hospital stays are valuable in achieving improved outcome and financial metrics.
authors.affiliation: Clinical Pharmacy Services, Carolinas HealthCare System, Charlotte, NC.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Bear
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000191:economics*; D003191:Comprehensive Health Care / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D059408:Pain Management / Q000191:economics*; D010149:Postoperative Pain / Q000188:drug therapy / Q000191:economics*