ArticleBMJ open2022
Mixed methods evaluation of the Getting it Right First Time programme in elective orthopaedic surgery in England: an analysis from the National Joint Registry and Hospital Episode Statistics.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Carbon savings associated with changing surgical trends in total knee arthroplasty in England: a retrospective observational study using administrative data.Annals of the Royal College of Surgeons of England · 2025Observational
- Why do orthopaedic surgeons get sued? An analysis of £2.2 billion in claims against NHS England: trends in litigation and strategies to enhance care.Archives of orthopaedic and trauma surgery · 2025Article
- Bolus-Tracked Biphasic Contrast-Enhanced CT Imaging Following Microwave Liver Ablation Improves Ablation Zone Conspicuity and Semi-automatic Segmentation Quality.Cardiovascular and interventional radiology · 2025Article
- A Bibliometric Analysis of the Top 50 Most Cited Articles on Iatrogenic Nerve Injuries of the Upper Limb Following Surgery.Journal of brachial plexus and peripheral nerve injury · 2025Review
- Estimated Carbon Savings from Changing Surgical Trends in Primary Elective Total Hip Arthroplasty in England: A Retrospective Observational Study.Applied health economics and health policy · 2025Observational
- Mixed Methods EvAluation of the high-volume low-complexity Surgical hUb pRogrammE (MEASURE): a mixed methods study protocol.BMJ open · 2024Article
- Article
- Implementation of the national Getting it Right First Time orthopaedic programme in England: a qualitative case study analysis.BMJ open · 2023Article
Corrections and comments
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Authors and funding
13 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveTo evaluate the impact of the 'Getting it Right First Time' (GIRFT) national improvement programme in orthopaedics, which started in 2012.
designMixed-methods study comprising statistical analysis of linked national datasets (National Joint Registry; Hospital Episode Statistics; Patient-Reported Outcomes); economic analysis and qualitative case studies in six National Health Service (NHS) Trusts.
settingNHS elective orthopaedic surgery in England.
participants736 088 patients who underwent primary hip or knee replacement at 126 NHS Trusts between 1 April 2009 and 31 March 2018, plus 50 NHS staff.
interventionImprovement bundle including 'deep dive' visits by senior clinician to NHS Trusts, informed by bespoke set of routine performance data, to discuss how improvements could be made locally.
main outcome measuresNumber of procedures conducted by low volume surgeons; use of uncemented hip implants in patients >65; arthroscopy in year prior to knee replacement; hospital length of stay; emergency readmissions within 30 days; revision surgery within 1 year; health-related quality of life and functional status.
resultsNational trends demonstrated substantial improvements beginning prior to GIRFT. Between 2012 and 2018, there were reductions in procedures by low volume surgeons (ORs (95% CI) hips 0.58 (0.53 to 0.63), knees 0.77 (0.72 to 0.83)); uncemented hip prostheses in >65 s (OR 0.56 (0.51 to 0.61)); knee arthroscopies before surgery (OR 0.48 (0.41 to 0.56)) and mean length of stay (hips -0.90 (-1.00 to -0.81), knees -0.74 days (-0.82 to -0.66)). The additional impact of visits was mixed and comprised an overall economic saving of £431 848 between 2012 and 2018, but this was offset by the costs of the visits. Staff reported that GIRFT's influence ranged from procurement changes to improved regional collaboration.
conclusionNationally, we found substantial improvements in care, but the specific contribution of GIRFT cannot be reliably estimated due to other concurrent initiatives. Our approach enabled additional analysis of the discrete impact of GIRFT visits.
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