Patient Reported Outcomes

CJRR Is First Orthopedics Registry in United States to Release Patient-Reported Outcomes By Hospital

The California Joint Replacement Registry (CJRR) is pleased to announce the release of patient-reported outcome (PRO) data by named hospitals that voluntarily participate in the registry and agreed to this release.

This release, a significant milestone, marks the first time an orthopedic registry in the United States has publicly published such data by hospital. The CJRR hopes this release will serve to further the national dialogue around PROs and the importance of seeking and sharing direct feedback from patients about health care outcomes.

Why are PROs Important?

A PRO survey asks patients questions about their overall health, including movement, pain, fatigue and mood. The CJRR collects PROs via surveys of patients about their pain and function before and after joint replacement surgery to determine whether surgery improved quality of life. These data are essential to facilitate shared decision-making, drive care improvement, and support new payment and delivery models anchored in patient-centered care.

The CJRR is reporting two types of results:

  • The percent of patients that reported meaningful improvement in their physical abilities after hip or knee joint replacement surgery
  • The percent of all patients who had surgery and completed a survey (response rate)

Participating Hospitals

The CJRR commends participating hospitals for contributing data and spearheading release of this important data.

The hospitals listed below chose to participate in the CJRR voluntarily and agreed to release their PRO-related performance publicly. They are supportive of the CJRR’s mission to promote transparency by collecting and reporting data on the results of hip and knee replacements performed in California.

This first PRO release features a limited set of hospitals, as not all 45 participants have a statistically significant number of responses to be included in this report. As noted in the table (below), the results for participating hospitals reported at this time do not show wide variation. Future reporting will build upon this effort. We expect to share data about additional California hospitals as PRO surveys are more routinely fielded at more hospitals, and as each facility accumulates more data pre- and post-surgery.

Answers to some frequently asked questions about CJRR’s PRO data release are available here: Public Reporting FAQs.


CJRR collects PRO data using three surveys: VR-12, the HOOS/KOOS Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the UCLA Activity Index. At this time, the CJRR is reporting meaningful changes in the WOMAC score. WOMAC uses 24 questions to measure pain and function. We are also reporting the percent of all patients who had surgery and completed a survey (response rate) for each participating hospital. These results are risk-adjusted in order to control for the diseases, conditions and other patient characteristics that could cause PRO data to vary due to circumstances outside of a provider’s control.

The risk-adjustment approach compares each hospital’s risk-adjusted PRO rate to all participating hospitals’ overall rate to identify whether each hospital is better, as expected or worse than expected.

More information about the risk-adjustment approach used by CJRR is available here: CJRR PRO Risk-Adjustment Model.

Hospital Ratings

These results are based on data collected in CJRR about surgeries that occurred from April 1, 2011 to November 6, 2014. The calculations are current as of December 31, 2014. Hospitals may have had a larger number of surgeries during this time period. Only those patients that completed both a pre-surgical survey and a follow-up survey one year after surgery are included here. Different hospitals started collecting CJRR data at different times during this period. Hospitals with a small number of responses may have joined the CJRR later in the reporting period.

Ratings Key

Percent of Patients That Reported a Meaningful Improvement in Their Physicial Abilities After Hip and Knee Joint Replacement Surgery, by Hospital

Hospital Patients That Had Orthopedic Surgery1 Orthopedic Surgery Patients That Completed a Survey2 Response Rate3 % of Patients That Reported
Meaningful Improvement4
University of California, San Francisco79355469.90%
3 star rating
Stanford University Medical Center3276620.20%
3 star rating
Hoag Orthopedic Institute30781996.50%
3 star rating
St. Joseph Hospital of Orange1284535.20%
3 star rating
John Muir Medical Center - Walnut Creek2244218.80%
3 star rating
Cedars-Sinai Medical Center4997214.40%
3 star rating
Alta Bates Summit Medical Center - Alta Bates campusN/AN/AN/ADeclined to Report
Alta Bates Summit Medical Center - Summit campusN/AN/AN/ADeclined to Report
Eisenhower Medical Center 8112.50%Insufficient Data Available
John Muir Medical Center - Concord932729.00%Insufficient Data Available
PIH Health1722414.00%Insufficient Data Available
Scripps Green Hospital19947.40%Insufficient Data Available
St. Bernardine Medical Center2150.00%Insufficient Data Available
St. Jude Medical Center531528.30%Insufficient Data Available


1 – Count of Patients That Had Orthopedic Surgery
2 – Count of Patients That Had Orthopedic Surgery and Completed a Survey About How Their Physicial Abilities Changed After Surgery
3 – Percent of All Patients That Had Surgery and Completed a Survey (Response Rate)
4 – Percent of Patients That Reported Meaningful Improvement in Their Physicial Abilities After Surgery – Adjusted for Differences in Patient Health