Edition 10/2020
September 10, 2020
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Day surgery pilot program flying high By Tim Howard IMAGINE literally walking out of the doctors surgery, unaided, within 24 hours of a knee or hip replacement. What seemed like science fiction just a year or two ago, happened for the first time at Grafton Base Hospital last month. On August 24 the first two patients in same day joint replacement pilot program both underwent knee replacement surgery and were able to discharge themselves from hospital care within 24 hours. The two patients, Susan Robertson Halil, from Lawrence and Sandy Van Veluewen, from Moonee Beach were over the moon at the result of the operation. Ten days later they were back in the hospital’s new $17.5 million ambulatory care centre for a check up, which they passed with flying colours. “The operation succeeded way beyond what we believed was possible,” said Ms Van Veluewen. “The pain after the operation has been minimal and I’ve had no problem moving about.” Ms Robertson Halil said as a former nurse, she knew minimal post-operative care was going to be essential. “I knew what type of patient I would be in rehab, so I knew I had to be out of there as soon as possible,” she said. “I had not qualms about leaving hospital 24 hours after the operation. In fact I was out seven hours after surgery.” She said getting home quickly was important for patients who did not need intensive post operative care. “You do more for yourself at home,” she said. “You have to do more things, get up, get a cup of tea, help the kids do something. “If you’re sitting around in your bed at hospital, you’re not helping yourself and your recovery takes longer.”
Dr Sam Martin checks on the recovery of joint replacement day surgery patient Sandy Van Veluewen. Ms Robertson Halil also confessed she was determined to make her recovery a success to help the driving force behind the pilot program, orthopaedic surgeon, Dr Sam Martin. “I love Dr Martin,” she said. “I tell him that every time I see him.” Dr Martin head up a team at the hospital that has been developing the pilot program over the past two to three years. He said hospital care periods after joint surgery had been falling during to advanced surgical and anaesthetic techniques and better post operative pain management, but four to five days in hospital was still the norm after most operations. “There is compelling evidence that for many patients, a day stay joint
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replacement is safe with equal or better results compared to a longer hospital stay, in terms of the patient’s return to function,” he said. “We also know that getting moving again soon after surgery is shown to reduce the recovery time for patients. “Within three to four hours of the surgery, under the care of our physiotherapy team, patients can begin moving, and will remain in hospital for at least six hours before than go home. “This is a significant achievement for a small regional centre like Grafton.” The general manager of Clarence Health Service, Dan Madden, said the success of the program was due to the team who had put it together. “This program is really the culmination of an outstanding team
effort from surgeons and anaesthetists to nursing staff and allied health staff who support the patients before and after surgery,” Mr Madden said. He said many aspect contribute to a successful day stay total joint replacement, including a streamline preoperative physiotherapy and education program, a focused operating theatre unit, tailored anaesthetic and surgical techniques and nursing staff skilled in shorter stay surgery.’ He said the pilot program would run for another six months and its results would be written up into a scientific paper to be peer reviewed.
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