Joint Replacement Patients Are Not Sick
Biloine W. Young • Tue, February 16th, 2016
Sentara Halifax Regional Hospital, located in South Boston, has implemented a most atypical program for its joint replacement patients. The program is based on a national best practice model and is structured around the fundamental principle of wellness.
The program starts with the assumption that these patients are not sick.
“This is not your typical hip and knee replacement surgery hospital stay, ” claimed orthopedic surgeon, Mesfin R. Shibeshi, D.O. Shibeshi, along with a team of orthopedic surgeons, administrative staff and Orthopedic Patient Navigator Shannon Brown, R.N., has implemented this program at Sentara Halifax Regional Hospital in an attempt to improve outcomes and provide a superior experience for individuals having hip or knee replacement surgery.
“It is important to recognize that we do not see these patients as being sick, ” Shibeshi said. “Alternatively, we look at these patients as healthy people who are coming to us because they have hip or knee pain and want to improve their quality of life by undergoing joint replacement surgery.”
This concept of wellness is at the forefront during the entire program, which incorporates the most advanced minimally invasive, analgesic and rapid-recovery surgical techniques. The program’s patient environment maximizes patient recovery through pre-op education, a culture of early mobility, family involvement and group interaction.
The Sentara OrthoJoint Center experience begins in the physician’s office. Once patients decide to have joint replacement surgery, they are given a comprehensive guidebook, explaining their upcoming surgery, and a list of activities, including pre-operative strengthening exercises they need to begin prior to surgery. This guidebook also serves as a clinical diary that the patient brings to the pre-operative class, all appointments and the hospital.
Each patient chooses a coach, who wears a special coaches’ badge and who is an active participant in the patient’s care before, during and after discharge from the hospital. Both patient and coach are required to attend a pre-operative class one to two weeks prior to surgery.
An orthopedic patient navigator oversees the patient’s entire stay and is his resource before, during and after discharge. Patients do not wear hospital gowns, but rather they bring comfortable clothes—shorts, T-shirts—which they wear during the day.
Each day, which begins at 6 a.m., patients receive newsletters that are specific to their particular surgery, letting them know what is on the agenda for the day.
Two group therapy sessions are held daily. Motivational posters are located throughout the halls and an exercise tracking board provides a guide for patients to track their success. Patients compete with one another on distance walked each day. All progress is tracked using magnets on this exercise board that is located in a common area.
Discharged patients receive calls from the Sentara OrthoJoint Center staff within 72 hours of discharge and again one to two weeks later. Reunions for Sentara OrthoJoint Center graduates and their coaches are held quarterly with surgeons and their entire team. According to national best practice studies, the result of this new approach to surgery is less pain, quicker recovery and superior outcomes.
“We evaluate each patient on multiple clinical, functional and patient satisfaction criteria, ” said Chris A. Lumsden, president of Sentara Halifax Regional Hospital. “These outcomes are then analyzed during monthly performance improvement team meetings and enable Sentara Halifax Regional Hospital to become masters of teamwork. So, when we say we offer superior outcomes, we have the data to prove it.”