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An image of the exterior of Upstate Community Hospital.

Excellus BCBS names several Upstate joint replacement and surgery programs Blue Distinction Centers

Upstate University Hospital and Upstate Community Hospital have earned Blue Distinction Center designations for their orthopedic knee, hip and spine programs by Excellus BlueCross BlueShield.

Excellus BCBS has named the following designations:

  • Knee and hip replacement program at Upstate Community Hospital as a Blue Distinction Center Plus (BDC+) program.
  • Knee and hip replacement program at Upstate University Hospital as a Blue Distinction Center program.
  • Spine program at Upstate University Hospital as a Blue Distinction Center program.

All designations were effective Jan. 1, 2020.

Blue Distinction Centers are nationally designated healthcare facilities shown to deliver improved patient safety and better health outcomes, based on objective measures that were developed by Blue Cross and Blue Shield companies with input from the medical community.

Obtaining Blue Distinction status is an important designation for when patients are making decisions about their care, said Upstate staff involved in the application.

“This designation demonstrates the great quality outcomes we have in patient care for our patients,” said Sharon Klaiber, MS, RN, NEA-BC, former deputy director of nursing at Community Hospital. “We have been nationally designated by DNV for our joint replacement program and the Blue Distinction Specialty designation demonstrates the work we are doing to continually improve and build upon our great outcomes for our orthopedic patients.”

Hospitals designated as Blue Distinction Centers for spine surgery demonstrate expertise in cervical and lumbar fusion, cervical laminectomy and lumbar laminectomy/discectomy procedures, resulting in fewer patient complications and hospital readmissions compared to other hospitals.

Hospitals designated as Blue Distinction Centers+ for knee and hip replacement demonstrate expertise in total knee and total hip replacement surgeries, resulting in fewer patient complications and hospital readmissions. In addition to meeting these quality thresholds, hospitals designated as Blue Distinction Centers+ are on average 20 percent more cost-efficient in an episode of care compared to other hospitals.

Designated hospitals must also maintain national accreditation.

Many Central New Yorkers choose Upstate for their orthopedic care. From July 2017 through June 2018 Upstate performed 425 total knee replacements; 351 total hip replacements; and 585 procedures on the spine.

“This really recognizes the great program that we have here,” said Sally Ramsden, RN, director of quality and risk services at Upstate. “This designation from Excellus BCBS, which is nationally recognized, showcases the great care and great things that are happening here.

“It’s a great honor for us to receive.”

Ramsden said the application for BDC did not require Upstate to make any changes to its spine, hip or knee programs – only to gather information and data about existing practices and procedures.

“We’ve been doing all of the things that this requires for some time,” she said. “It was gathering the data to show that we met the criteria.”

Upstate was eager to talk about its commitment to shared decision-making between patients and their doctors, which was something the application looked for, Ramsden said.

“This program really fostered shared decision making and to me that’s a big plus to the program,” Ramsden said. “Shared decision making means you the patient have as much say into your plan and process as the surgeon does. So it’s really a joint decision as to what we’re going to do, how we’re going to do it, what your progress is going to be, what your rehab will be and more.”

Shared decision making has been shown to decrease anxiety, increase compliance with treatment regimens and speed recoveries, she said.

The designation from Excellus BlueCross BlueShield recognizes the tremendous care Upstate provides the community, said James Cavalluzzi, BSN, RN, CNOR, nurse manager for the adult operating room where many of the hospital’s spine surgeries take place.

“The designation honors the facility for all of the hard work that it’s done,” Cavalluzzi said. “We’ve always taken a team approach to the care that we’ve provided to patients. Upstate provides tremendous comfort and care to patients in our community and it’s nice to be recognized for that.”

He added that the designation will help patients make important decisions about their care.

The Blue Distinction Center designation “offers patients a good starting point for where they want to go and who they want to entrust with the care they are going to receive,” Cavalluzzi said.

Blue Distinction Centers (BDC) met overall quality measures, developed with input from the medical community. A Local Blue Plan may require additional criteria for providers located in its own service area; for details, contact your Local Blue Plan. Blue Distinction Centers+ (BDC+) also met cost measures that address consumers’ need for affordable healthcare. Each provider’s cost of care is evaluated using data from its Local Blue Plan. Providers in CA, ID, NY, PA, and WA may lie in two Local Blue Plans’ areas, resulting in two evaluations for cost of care; and their own Local Blue Plans decide whether one or both cost of care evaluation(s) must meet BDC+ national criteria. National criteria for BDC and BDC+ are displayed on www.bcbs.com. Individual outcomes may vary. For details on a provider’s in-network status or your own policy’s coverage, contact your Local Blue Plan and ask your provider before making an appointment. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for non-covered charges or other losses or damages resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers.

Caption: Upstate Community Hospital.