Twin Cities Orthopedics (TCO) values a close working relationship with the staff at its affiliated hospitals and surgery centers. These relationships help ensure referred patients are offered complete care before and after they undergo surgery.
In the case of joint replacement surgery, the TCO staff has worked closely with the staff at the Ridgeview Medical Center, Center for Joint Replacement; the Joint Center at North Memorial Medical Hospital; and the Joint Replacement Center at Abbott Northwestern Hospital to develop an educational and therapeutic experience for patients that has proved to improve both patient outcomes and patient satisfaction.
The group experience
The experience begins with a pre-operative educational session filled with as little as four or as many as 20 patients; most of whom will also participate together in group physical therapy sessions following surgery.
While attending the pre-operative educational session, patients are given educational reference guides filled with answers to common questions such as: What does my new joint replacement look like? When will I be able to walk again? When will the pain go away? Sessions are guided by occupational and physical therapists who are also available to help answer additional questions and calm anxieties.
Patients are encouraged to bring a friend or family member to act as a coach. “We encourage the coach to come to all of the hospital visits including the pre-operative educational session, the therapy sessions, and the nursing education sessions,” said Katie Trent, a physical therapist and program coordinator at Ridgeview Medical Center,Center for Joint Replacement. “There is so much going on, it is helpful for the patient to have someone listening and learning with them. It also makes everyone more confident when it’s time to go home.”
Joint Replacement Education Program
In addition to Ridgeview Medical Center, North Memorial Medical Center and Abbott Northwestern Hospital, TCO physicians have also worked with the staff at Fairview Southdale Hospital to develop the Total Joint Replacement Education Program. This comprehensive and popular class prepares patients and their families for surgery, their hospital stay, rehabilitation, and long-range goals that might include returning to an active lifestyle.
“Our patients love the education they receive,” said Deb Smith, RN, a clinical nurse/educator at Fairview Southdale Hospital. “In fact, one total knee replacement patient comes to the class every Monday to tell others who are contemplating joint replacement how valuable the information is and how happy he is with his outcome.”
Pre- and postoperative physical therapy
Patients at Ridgeview Medical Center, North Memorial Medical Center, and Abbott Northwestern Hospital are encouraged to participate in a pre-operative physical therapy session. Exercise participation prior to total joint arthroplasty dramatically reduces the odds of requiring transfer to a swing bed or another inpatient facility, according to research noted in Arthritis & Rheumatism, the official monthly journal of the American College of Rheumatology.
Patients also participate in postoperative group physical therapy sessions prior to being discharged. Group physical therapy sessions give patients extra motivation and allow opportunity for greater support as they begin their road to recovery. Targeted postoperative care has resulted in more patients being discharged directly home after hip or knee arthroplasty, as indicated in research that appears in the Archives of Physical Medicine and Rehabilitation.
The results
Ridgeview Medical Center began offering this group approach to education and therapy when it opened its Center for Joint Replacement in April 2007.
“Prior to opening the Center for Joint Replacement, 65 percent of our patients went home after surgery and 35 percent required nursing home care,” Trent said. “Now, only 20 percent of patients are discharged to a nursing home and 80 percent return home.”
In addition to the improvement of discharge status, the average hospital stay following joint replacement has decreased from 3.8 days to 3.15 days. In 2007, the center achieved a zero percent infection rate for all knee replacement surgeries and a 0.77 percent infection rate on all hip replacement surgeries. At North Memorial Medical Center, the improvements are similar. “The results of our program have been amazing,” said Chuck Lister, program coordinator at the Joint Center at North Memorial Medical Hospital. Since starting the program, the North Memorial Joint Replacement Center has seen a zero percent infection rate and the average hospital stays have decrease from 3.5 days to 3.1 days.
Abbott Northwestern Hospital is just starting their Joint Replacement Center but they are optimistic they will have similar results.
In addition to outcome statistics, patients are also more satisfied with the care they receive. “Today’s patient wants to take an active role in the treatment and recovery process,” Lister said. “Since implementing joint replacement classes, patients have been more satisfied with their ability to be involved and expedite the recovery process.”
Constant improvement
While the results of improvement in patient education and pre- and post-operative physical therapy have helped improve patient recovery and patient satisfaction, TCO and the hospitals it is affiliated with are continuously researching and looking for new ways to improve care.
For more information about TCO physicians, locations, and services offered, visit www.tcomn.com.
