2016-17 Sentara Orthopedics Annual Report

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Sentara OrthoJoint Center®

Each Sentara OrthoJoint Center® has a singular focus: the needs of orthopedic surgical patients undergoing hip or knee replacement. These ten centers concentrate their efforts on a dedicated team approach involving nurses, anesthesiologists, surgeons, physical therapists and home care. This centered approach improves both patient care and outcomes and has helped us provide surgical options for patients.

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Sentara Orthojoint Center Map

Highlights:

  • Two new locations for a new Sentara OrthoJoint Center were established: at Sentara Halifax Regional Hospital in early 2016 and another site at Sentara Albemarle Medical Center in early 2017.
  • In late 2016, Sentara RMH Medical Center branded their existing joint replacement program to become a Sentara OrthoJoint Center®. Sentara Martha Jefferson is anticipating doing the same in late 2017.
  • In late 2017, Sentara Martha Jefferson Hospital was designated the eleventh Sentara OrthoJoint Center®.
  • To better serve our diverse populations, a Spanish version of the Sentara OrthoJoint Center® Patient Guidebook was made available in 2016.

A Dedicated Orthopedic Patient Navigator at each facility continues to offer to patients the extra benefit of an informed and individualized joint replacement experience. The Patient Navigator helps foster open lines of communication between the patient, the patient’s family and the care team before, during and after surgery. With education being such an active component for joint replacement patients, the navigators continuously look for additional ways to keep their patients and the coaches informed on the latest information. This has resulted in the team of navigators developing and implementing several innovative patient-focused materials:

  • Ten Ways to Recover at Home. A two sided document developed to help patients and their surgeons to appreciate the advantages of being able to be discharged from the hospital directly to the comforts of home for a continued recovery. This document has since been adapted for other patients outside of orthopedic care.
  • Patient Commitment. Choosing to have elective orthopedic surgery does come with a commitment from the patient, and a coach to do their best to learn what they can do to have the very best outcomes. This three copy document bullets out the simple things that can optimize the experience and recovery.
  • StopLight Discharge Poster. With hospital stays after surgery becoming shorter, when patients are discharged from home, they need to know the guidelines for what is normal, what symptoms need to be discussed with a health care provider and what needs immediate attention.
  • Online educational video developed to offer 24/7 online access to patients and their families about the Sentara OrthoJoint Center® joint replacement experience

Joint Replacement in the morning — home the next or even the same day

The trend of shorter length of stays fueled the increased expansion of patients electing to have a one night length of stay in the hospital following joint replacement surgery. This option was initially offered at two locations in 2014, grew to four sites in 2015 and, in 2016, expanded to two additional locations: Sentara Princess Anne Hospital and Sentara Virginia Beach General Hospital. In late 2017, the Express Track option started being offered at Sentara Martha Jefferson Hospital where some patients are already returning home the day of surgery to continue their recovery.

Highlights of the Express Track:

  • Healthy patients interested in a shorter hospital stay are pre-screened by the surgeon before surgery.
  • Selected patients agree to prepare themselves and their coaches for a expedited recovery.
  • Pre-surgery education is imperative in setting expectations.
  • Strengthening exercises are recommend before surgery.

Express Track helps healthy patients recover more quickly after joint replacement. Getting patients up and walking the same day of surgery and aggressive physical therapy are key components to the success of the Express Track program.

It combines the high quality care of the Sentara OrthoJoint Center® with a shortened hospital stay. Patients leave the hospital the day after or even the day of their joint replacement surgery and continue recovering in the comfort of their own home. They have the option to be visited there by our expert team of home care providers.

Express Track is an optional program that requires a commitment on the part of the patient. To prepare for Express Track, patients receive pre-operative education and information, including a best practices guidebook that lets them know what to expect. The guidebook also provides patients with both pre-operative and post-operative exercises and manages their expectations regarding recovery.

Commitment to the Patient Experience: Patient Navigators

Sentara Patient Navigators are nurses with specialized training in orthopedics, helping them provide an extraordinary level of patient care in their role as liaisons between the patient, the physician and the hospital. The Patient Navigator assesses patient needs and provides personal, individualized care for each and every patient in the Sentara OrthoJoint Center® and the Sentara Back & Neck Center. Orthopedic Patient Navigators are available at all nine Sentara OrthoJoint Center® locations.

patient-navigator-soloThere are Orthopedic/Spine Patient Navigators at each Sentara OrthoJoint Center® and Sentara Back & Neck Center

Sentara Patient Navigators see patients multiple times and serve as a touch point for the patient and the patient’s family. They help ensure that patients are properly prepared to undergo surgery. Their assistance may include:

  • Preparing patients for surgery at a pre-operative class. Patients learn about pre-operative cleansing to minimize bacteria on the skin and lessen the chance of infection
  • Understanding each patient’s medical history and risk factors (making sure, for example, that a patient’s diabetes is being properly managed).
  • Coordinating all aspects of a patient’s care while in the hospital and after they leave. Responsibilities include arranging group physical therapy, providing discharge instructions and following up after the hospital stay.
  • Collaborating together and with the surgeons and other team members to continuously improve the patient experience.
  • Evaluating patient care and looking for ways to improve patient outcomes.
  • Conducting studies to see is simple changes can offer advantages for patients or their families.

William

“I injured my knee years ago playing football, and I put off any operations. I finally had the knee replacement surgery because I wanted to walk my daughter down the aisle and dance at her wedding. Since then, I’ve continued to be pain-free and can chase around my grandson and ride my bike.”

Dwan

“I had a hip replacement on my right side years ago, and over time, it seemed like everything shifted, and I began to feel deep pain in my left hip. I was glad I chose to have my second surgery. The Express Track Option included classes that explained everything to me, and it provided the chance to stay only one night in the hospital. I was up and around the next day. Now I’m able to walk around without a limp and pain-free.”

William

“I worked for many years as an orthopedic surgeon, and then, unfortunately, I experienced knee pain of my own. I decided to ask the people I worked with to do the surgery. The replacement went wonderfully. I got up and walked 600 feet only two hours after the surgery.”