National Model of Care for Hip and Knee Replacement
Knowledge Translation Network

Hazel Wood, BSc OT, MBA
Executive Director, Bone and Joint Canada

Rhona McGlasson, RPT, MBA
Programme Director, Bone and Joint Health Network

Over the last few years, Bone and Joint Canada has been working to develop a consensus around best practice care for hip and knee replacement. In October 2004, Bone and Joint Canada provided Health Canada with a phased approach to addressing musculoskeletal surgery wait times which included:

• Phase I: Engagement of orthopaedic surgeons, government and associated not-for-profit agencies.
• Phase II: Establishment of a framework/model of best practices to capture and communicate innovative ideas, methodologies and processes while being flexible enough to be applied in individual jurisdictions.
• Phase III: Development of Knowledge Translation Networks in each province to help influence change and develop sustainable solutions.

Phase I of the strategy was conducted through 2006 and 2007 in which leading orthopaedic surgeons from across the country, national not-for-profit agencies, hospital administrators and federal and provincial government officials were engaged to identify current models of care and key opinion leaders. In Phase II, which was conducted over 2007 and 2008, the various models from across Canada were reviewed and the following provinces were identified as having developed a comprehensive model of care: Alberta, British Columbia and Ontario. At a meeting in April 2008, the key opinion leaders from across the country identified the parameters of a programme that were important to create a successful Wait Times Model of Care.

Bone and Joint Canada is currently working to develop Phase III of the strategy. Phase III will take place through 2008 to March 2009 and will include the consolidation of the models from across the country to develop a core model as well as develop a Toolkit which provides best practice guidelines on the management of hip and knee replacement candidates. This Toolkit will represent care across the health care continuum and will include input from primary care and rheumatology. It is anticipated that this model and Toolkit will be flexible and adaptable to meet local and regional variation. 

Through Phase III, Bone and Joint Canada will also support the development of Knowledge Translation Networks in each province and territory and where there is interest, will offer to work with individual provinces and territories to implement the model. Using the Toolkit and the learning's gained through the pilot projects in Ontario, Alberta and British Columbia, BJC can help position the provinces and territories for success by capitalizing on positive experiences and avoiding pitfalls, thereby saving resources that can be directed towards patient care.

Through Phase III of the strategy, Bone and Joint Canada will be looking to work with the musculoskeletal health care community from across the country to assist in the development of this model and Toolkit. We hope to gain support from orthopaedic surgeons across Canada. Those interested in finding out more about this initiative, or who have an interest in providing feedback, should contact Dr. James P. Waddell at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .