Irish National Orthopaedic Register (INOR)

Data Collection Type
National data collections of health and social care in Ireland
Organisation

National Office of Clinical Audit

Year established

2014 — collection commenced at the development site.

Statement of purpose

To provide an electronic point of care system to record and monitor all elective orthopaedic surgical procedures performed in participating hospitals. Irish National Orthopaedic Register (INOR) will rely on patient scoring systems; adverse incident recording system and surgical revision rates to monitor implant performance and patient outcomes. This will provide continuous feedback to patients, participating centres and surgeons. Through the monitoring of joint replacement surgery and implant devices, INOR aims to reduce the cost of revision surgery in Ireland, to identify risk associated with joint replacement and thereby ensure that Irish patients receive the highest possible standard of orthopaedic care within our hospitals.

Coverage

All elective orthopaedic centres and independent hospitals in Ireland.

Description

INOR is an electronic point-of-care system, designed to collect demographic, clinical and implant component data on patients admitted to hospital for primary and revision arthroplasty surgery in hospitals nationally. 
The objectives of INOR are to: 

  • increase patient safety, confidence and overall experience
  • enable early detection of failing devices, procedures, institutions or surgeons or any combination (device, implanted materials, procedures, institutions and/or surgeons) to limit the impact for future patients
  • enable better identification and management of individuals in at-risk groups to improve patient experience and outcomes 
  • reduce surgical revision rates and improve both costs and patient outcomes 
  • optimise the pre-operative, peri-operative and post-operative process to improve quality of service
  • provide orthopaedic surgeons the opportunity to participate and contribute to measurable clinical audit 
  • to monitor implant performance against the group norms for Ireland and within the wider international community 
  • to monitor patient outcome and to use patient self-scoring as part of the indicator for device failure (and not just revision surgery).
Data content

Includes details of the following: pre-operative assessment (comorbidities/body mass index), peri-operative clinical data (diagnosis/procedure/implant component details), post-operative assessment (complications/incidents), Patient Reported Outcome Measures (PROMs), demographic patient details include name and gender.
Consent status (consent given/consent refused) is also collected and for non-consenting patients, no demographic data is stored on INOR.

Data providers

Includes details of the following: pre-operative assessment (comorbidities/body mass index), peri-operative clinical data (diagnosis/procedure/implant component details), post-operative assessment (complications/incidents), Patient Reported Outcome Measures (PROMs), demographic patient details include name and gender.
Consent status (consent given/consent refused) is also collected and for non-consenting patients, no demographic data is stored on INOR.

Data collection methodology

The INOR system is a web-based application that has been custom-built to help define the epidemiology of joint replacement surgery in Ireland. The INOR system and processes will record and monitor joint replacements nationally to improve outcome and patient experience. INOR data will provide timely information on the outcomes of joint replacements, identifying risk factors for poor outcome and will be used to assist in the assessment, training and education for clinicians. Data is entered directly onto INOR by nurses, surgeons and patients.
The INOR system collects data in real time in:

  • pre- and post-operative assessment units to record pre-operative Minimum Dataset (MDS) information, patient consent, post-operative assessment MDS information and PROMs
  • orthopaedic theatres to record peri-operative MDS information, components and to provide a post-operative note to consultants
  • NOCA to monitor and manage the system, including the provision of register reports.
Data dictionary
Clinical coding scheme

International Classification of Disease and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) for coding diagnoses and Australian Classification of Health interventions (ACHI) for procedures.

Size of national collection

Project currently in roll-out phase.

Publication frequency

Annual reports — once data collection commenced in all public hospitals.

Accessing data

NOCA Office — INOR Annual reports (national reports, surgeon reports, and hospital reports). 

Open data portal access

No

Email contact
Telephone contact
Other comments

Roll out to public hospitals expected to be completed in 2018.