An open letter to joint replacement professionals from Maureen Bisognano at the Institute for Healthcare Improvement and Professor Robert Kaplan at Harvard Business School


We’re writing to invite you to participate in a breakthrough learning community on joint replacement. We have joined together to improve value, or health outcomes per dollar spent, for hip and knee replacement patients, and we want you to join us.

One thing we have been hearing a lot lately is that hospitals across the country are facing increasing pressure for transparency, as evidence accrues of widespread variation in cost and quality. Assessing these critical aspects of care has proved difficult, and the present dearth of standardized and comparable information on outcomes and cost has hindered improvement. Providers rarely, if ever, know where they stand relative to their peers; and almost no provider properly calculates the cost (as opposed to the billing charges) of the care they provide.

This learning community will be limited to 25 organizations aiming to improve value for hip and knee replacement patients. Over 12 months, from January to December 2014, organizations will identify and act on process improvement opportunities through the application of cutting-edge costing techniques, standardized outcome measures, and process improvement strategies.
The faculty of the learning community will teach frameworks critical to achieving better value for patients:
  • We will offer instruction on using Time-Driven Activity-Based Costing (TDABC), which assesses the actual cost of delivering care through process mapping.
  • We will then help organizations use this data to identify areas to improve quality and reduce costs through its extensive expertise in learning community design and improvement coaching. In addition, we will assist organizations in developing and assessing a standard set of outcome measures.
This learning community offers a unique opportunity to apply analytic and improvement methods to position your organization as a leader in health care value. Your participation in this learning community will advance the science of caring for these high-volume patients and their families. The knowledge shared across this learning community will inevitably build momentum for change across the industry.
Many thanks for your consideration,


Maureen Bisognano
President and CEO of IHI

Robert Kaplan
Marvin Bower Professor of Leadership Development, Emeritus
Harvard Business School