Under a previous system, patients who had orthopedic surgery would not get out of bed until the day after surgery, would stay in the hospital for at least four days and probably be off work for three months, and would take at least six weeks to get into a car to drive. There was also uncertainty for the patient about obtaining physical therapy.
The changes allowed for a streamlined approach where planning occurred in plenty of time before surgery that allowed patients time to know their exercises, discuss local instead of general anesthesia, had a single point of contact for questions, had scheduled surgery, therapy, and was taught to get in and out of a car safely. A guidebook issued to the patients allows them to monitor their exercise program.
A joint coordinator "is the patient's advocate. If there is a nursing problem, they will tell her. If (the patients) they don't like the physician, or not happy with the therapist, they will tell (the coordinator). It is really truly value added and empowerment at that point of service," Garland says.
Increasing education for the patient has reduced "fear and confusion" among patients, Garland says. Improved collaboration among physicians and staff has reduced the possibility of turf wars, he adds.
The joint replacement procedure changes have resulted in significant improvements to patient care as well as ROI, according to Chevreaux.
For instance, she says, the system has seen decreased length of stays, from 4.35 to 2.96 days; improved distances that the patients are walking, as well as improvements in overall recovery. The number of patients sent directly home increased from 12% to 81%. As for costs, implant expenses were reduced lower than the national average, and the number of private pay patients increased 31%, she says.
"It is truly a paradigm shift how we are delivering health and wellness," Chevreaux says.