Enhancing the quality of international orthopedic medical mission trips using the blue distinction criteria for knee and hip replacement centers

Kyle E Dempsey, Roya Ghazinouri, Desiree Diez, Luis Alcantara, Carolyn Beagan, Barbara Aggouras, Monica Hoagland, Thomas S Thornhill, Jeffrey N Katz

Several organizations seek to address the growing burden of arthritis in developing countries by providing total joint replacements (TJR) to patients with advanced arthritis who otherwise would not have access to these procedures. Because these mission trips operate in resource poor environments, some of the features typically associated with high quality care may be difficult to implement. In the U.S., many hospitals that perform TJRs use the Blue Cross/Shield's Blue Distinction criteria as benchmarks of high quality care. Although these criteria were designed for use in the U.S., we applied them to Operation Walk (Op-Walk) Boston's medical mission trip to the Dominican Republic. Evaluating the program using these criteria illustrated that the program provides high quality care and, more importantly, helped the program to find areas of improvement.