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Helping Patients Achieve Optimal Success After Joint Replacement Surgery Piedmont Joint Replacement Center of High Point Regional Health System
Cover Feature
Helping Patients Achieve Optimal Success After Joint Replacement Surgery
Piedmont Joint Replacement Center at High Point Regional
Health System
At the Piedmont Joint Replacement Center at High Point Regional Health System in High Point, NC, the quality of services provided extends far beyond the confines of the operating room. Comprehensive patient education, specially trained staff, and a team approach all contribute to helping patients achieve superior outcomes after joint replacement surgery.
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he Piedmont Joint Replacement Center — an 18-bed unit devoted solely to patients who have undergone an elective hip, knee or shoulder joint replacement procedure — delivers high-quality care while providing exceptional patient-focused service. The center’s commitment to teamwork, a patient-centric care delivery model and a family environment has resulted in sustained Press Ganey patient satisfaction scores in the 99th percentile. Beginning with initial engagement with patients during presurgical education, to their postsurgical unit experience to postdischarge follow up, the Piedmont Joint Replacement Center staff have one common goal – to deliver a “wow” experience to their patients. Physical therapy assistant Candace Riedl assists a patient participating in one of the Piedmont Joint Replacement Center’s Joint Camp therapy groups
A Unique Approach to Rehabilitation The Piedmont Joint Replacement Center program is based on the “Joint Camp” model, designed to help patients motivate and inspire one another as they progress through an intensive therapy program and work hard together to return to an active lifestyle after surgery. The Joint Camp program was developed in partnership with TeleVisual Communications, Inc. (TVC) — a Florida-based company that has developed a Joint Ventures program that outlines best practices for joint replacement surgery and rehabilitation. “Several years ago, we began considering the idea that group physical therapy for all patients might be more beneficial than isolated, individual therapy,” says Edward Weller, M.D., Co-Medical Director of the Piedmont Joint Replacement Center. “By putting patients in a setting where they could work together, see that other patients are experiencing the same road blocks and motivate one another, we believed patients would be more likely to succeed during rehabilitation. So far, results have been tremendous.” On the Piedmont Joint Replacement Center, patients are scheduled for surgery in several distinct groups. Patients and family members in each group go through presurgical education together, share the postsurgical experience together and progress through therapy and achieve their goals together. Creating a family atmosphere among patients is a major point of emphasis for staff members at Piedmont Joint Replacement Center. No matter how well prepared and educated a patient may be preoperatively, joint replacement procedures are major surgery, and patients may experience anxiety, pain and other challenges postsurgery. The Joint Camp environment and
Tony Stewart, a R.N. with years of experience caring for patients who have undergone joint-replacement surgery, assesses a Joint Camp member.
family-focused approach promotes a sense of genuine camaraderie and support between patients that empowers them to overcome those challenges together. “Patients receive individual therapy in the morning and then have group rehabilitation in a gymnasium in the afternoon,” says Mark A. Rowley, M.D., Co-Medical Director of the Piedmont Joint Replacement Center. “This allows patients to develop camaraderie among one another and, sometimes, even a little friendly competition, which motivates all patients to do the work necessary to regain the lifestyle they had before chronic pain began affecting their quality of life.” From the clothes patients wear — T-shirts and shorts, rather than hospital gowns — to the interior design of the unit, the atmosphere at Piedmont Joint Replacement Center was designed to have a camp-like feel for patients. Along the walls in 10-feet increments, pictures of different states have been hung for the “Walk Your Way Around the United States” program, which encourages patients to walk to a new state each time they walk down the hallways as part of their rehabilitation. Therapy is fun, interactive and a shared experience. “One of our greatest strengths is our staff,” says Jodi Dixon, R.N., B.S.N., B.C., Manager of the Piedmont Joint Replacement Center. “Our nursing assistants, nurses and physical and occupational therapy staff are experts in the care of joint replacement patients. They inspire our patients to really work together as a team to achieve their goals. Many of our patients develop relationships with one another throughout their hospital stay and even exchange phone numbers at the time of discharge.”
An Emphasis on Education Patients and members of their support system are expected to participate in a preoperative joint surgery class that educates them regarding what to expect throughout the surgical process and during recovery and rehabilitation. This training also sets the tone for their stay at the Piedmont Joint Replacement Center — that they will be committed to the hard work expected of them post-operatively that is so essential to the best outcome possible. Customized education materials, including DVDs, pamphlets and helpful hint sheets, specifically designed to provide patients with exactly the information they will need throughout their surgical journey, are also provided. Empowering patients and their families with this information has resulted in knowledgeable, calm and confident patients who know exactly what to expect before, during and after their procedure. “One of the things that helps keep our satisfaction so high is the consistency of care that patients experience,” says Dr. Rowley. “All patients follow the same clinical pathway, which begins with the Joint Camp educational seminar that patients participate in with their family members.” Community educational seminars are also held monthly for people who are experiencing chronic pain, mobility issues impacting their quality of life or other orthopedic problems. These seminars outline both the conservative measures, alternative therapies and surgical options available to today’s health care consumers. Providing Continuity of Care The team-like atmosphere that has been established at the
Orthopedic Patient Care Coordinator Ann Marie Taylor conducts preoperative education with patients scheduled for joint-replacement surgery
Piedmont Joint Replacement Center is one of the program’s most critical success factors. The team is comprised of many roles, from the orthopedic surgeons who perform the operations and their nurse practitioners and physician assistants, to nursing and physical and occupational therapy staff, who consistently work together to optimize care. “At the Piedmont Joint Replacement Center, we have a very highly trained and dedicated staff who truly work together with only one goal — to provide the absolute best care possible to our patients,” says John Jeffries, Director of the Piedmont Joint Replacement Center.
Promoting Best Practices The Piedmont Joint Replacement Center is intensely focused on ensuring the highest-quality care possible is provided. Those efforts have produced a number of best practices that help to prevent complications, such as postoperative infections, patient falls and occurrence of deep vein thrombosis. Because patients participate in a rigorous therapy program after surgery, pain control is key to ensuring rehabilitation is successful. Prior to surgery, patients will see a pain management specialist, and a plan to optimally control their pain is created. This plan may include traditional medication regimes but may also include cutting-edge techniques and devices, and alternative approaches to pain control. The patient’s involvement in developing a plan to manage their postoperative pain is critically important and allows for a faster recovery with fewer side effects experienced. Reducing the risk of infections is a top priority. Strict adherence by all team members to a vigilant handwashing Reprinted from Piedmont Triad md news
program is the most effective tool in infection control and is energetically monitored. Additional measures include the exclusive use of private rooms, aggressive watchfulness for signs of infection, and screening and protective protocols for resistant organisms. Preventing patient falls and complications such as deep vein thrombosis are also top priorities. The Piedmont Joint Replacement Center has implemented a number of strategies to ensure it continues to have one of the lowest incidences of falls and complications possible. In an effort to continuously improve quality and safety, staff — including physicians, nursing specialists, pharmacy representatives, physical therapists, operating room representatives and nurses from infection control — meet together monthly to evaluate the protocols and services in place so that successful outcomes are consistently achieved. Led by Orthopedic Patient Care Coordinator Ann Marie Taylor, the Orthopedic Group Practice Team is the engine driving continuous process and outcome improvement for the joint replacement program. “We have a dynamic group of people that are involved in the statistical analysis of all of our protocols, which ensures our complication and readmission rates are very low,” says Dr. Weller. “We make sure that all of our programs are being appropriately monitored, and our results are excellent when compared to national averages.” To learn more about the Piedmont Joint Replacement Center at High Point Regional Health System, visit www.highpointregional. com/ourservices/joint-replacement. n