Background Many patients undergo both THA and spinal arthrodesis, and those patients may not fare as well as those who undergo one procedure but not the other. The mechanisms of how spinal arthrodesis affects patient function after THA remain unclear. Questions/purposes The aims of our study were to (1) determine how patient-reported outcome measures (PROMs), including the Oxford hip score as well as

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Background: Positive deviance (PD) seminars, which have shown excellent results in improving the quality of surgical practices, use individual performance feedback to identify team members who outperform their peers; the strategies from those with exemplary performance are used to improve team members' practices. Our study aimed to use the PD approach with arthroplasty surgeons and nurses to identify multi disciplinary strategies and recommendations to improve operating room (OR) efficiency. Methods:We recruited 5 surgeons who performed high-volume primary arthroplasty and had participated in 4-joint rooms since 2012, and 29 nurses who had participated in 4-joint rooms and in at least 16 cases in our data set. Three 1-hour PD sessions were held in February and March 2021: 1 with surgeons, 1 with nurses, and 1 with both surgeons and nurses to select recommendations for implementation. The sessions were led by a member of the nonorthopedic surgical faculty who was familiar with the subjects discussed and with PD seminars. To determine the success of the recommendations, we compared OR efficiency before and after implementation. We defined success as performance of 4 joint procedures within 8 hours.Results: Eleven recommendations were recorded from the session with nurses and 7 from the session with surgeons, of which 11 were selected for implementation. During the month after implementation, there were great improvements across all time intervals of surgical procedures, with the greatest improvements seen in mean anesthesia preparation time in the room (4.51 min [26.3%]), mean procedure duration (9.75 min [14.0%]) and mean anesthesia finish time (5.78 min [44.0%]) (all p < 0.001). The total time saved per day was 49.84 minutes; this led to a success rate of 69.0%, a relative increase of 73.8% from our 2012-2020 success rate of 39.7% (p < 0.001). Conclusion:The recommendations and increased motivation owing to the individualized feedback reduced time spent per case, allowing more days to finish on time. Positive deviance seminars offer an inexpensive, efficient and collegial means for process improvement in the OR. Contexte :Les séminaires de déviance positive (DP), une approche qui a déjà donné d'excellents résultats en termes d'amélioration de la qualité des pratiques chirurgicales, recourent à la rétroaction sur le rendement individuel pour identifier les membres des équipes dont le rendement excède celui de leurs pairs; les stratégies associées à tout rendement exemplaire servent à améliorer les pratiques des membres des équipes. Notre étude visait à utiliser la DP comme approche pour les chirurgiennes et chirurgiens et le personnel infirmier spécialisés en arthroplastie afin d'identifier des stratégies et des recommandations multidisciplinaires pour améliorer l'efficience des blocs opératoires (BO). Méthodes : Nous avons recruté 5 spécialistes dont le volume d'interventions pour arthroplastie primaire était élevé et qui oeuvraient dans des blocs à 4 interventions chirurgicales depuis 2012, et 29 membres du pers...