Monongahela Valley Hospital Introduces new Concept in Joint Replacement Surgery
(January 21, 2013 - Carroll Township, Pa.)
Monongahela Valley Hospital (MVH) is changing the way patients and their families think about and experience joint replacement surgery with the introduction of The Orthopedic Institute at Monongahela Valley Hospital. The Orthopedic Institute is a comprehensive program that is based on a proven national model for hip and knee replacements. The program is structured around the fundamental principle of wellness.
"This is not your typical hospital program or hospital stay," said Thomas F. Brockmeyer, M.D. Ph.D., medical director of the Institute. Dr. Brockmeyer is one of three orthopedic surgeons who, along with the administrative and clinical team at MVH developed this innovative program to improve outcomes and provide a superior experience for individuals having hip or knee replacement surgery. Scott L. Baron, M.D., who is has an outstanding reputation for total hip and knee replacements, and Ari E. Pressman, M.D., whose areas of expertise include total hip and knee replacements as well as revision joint replacements, and Richard Mitchell, M.D., whose area of expertise is in the diagnosis and treatment of injuries to the shoulder, elbow, knee, and ankle, partner with Dr. Brockmeyer at the Orthopedic Institute.
"First and foremost, we do not see our patients as being sick," Dr. Brockmeyer explained. "Instead, we see our patients as healthy individuals who are coming to the hospital because they have hip or knee pain, and want to live a better quality of life by having joint replacement surgery."
The Orthopedic Institute Experience
This fundamental concept of wellness is implemented throughout the entire program, which incorporates the most advanced minimally invasive, analgesic, and rapid-recovery surgical techniques - with an environment that maximizes patient recovery through education, a culture of early mobility, family involvement, and group interaction.
The Orthopedic Institute experience actually begins in the physician's office. Once someone decides to have joint replacement surgery, they are provided with a comprehensive guidebook, explaining their upcoming surgery and a list of activities, including pre-operative strengthening exercises that they need to begin prior to surgery. This guidebook also serves as a clinical diary that is brought to pre-operative class, to all appointments, and to the hospital.
Key components of the program include:
- Individuals having elective surgery are considered students rather than patients.
- Each student chooses a coach - usually a family member or close friend - who is an active participant in their loved one's care before, during and after discharge from the hospital. Both student and coach are required to attend a pre-operative class two weeks prior to surgery where they meet their team from the Orthopedic Institute in addition to learning in details about the procedure, what to expect in the hospital, and care necessary after discharge. Coaches, who wear a special coach's button, learn the program right along with their loved ones, and provide encouragement and support every step of the way.
- A designated care coordinator oversees the student's entire stay and is their resource before, during and after discharge. Lorraine Damich, RN, BSN, who has been on staff at MVH for more than 30 years and has experience in nearly every department or unit, is the care coordinator.
- Each staff member receives special training, and is chosen to work on the unit because of his or her expertise; positive, upbeat nature; and high motivational skills.
- Students do not wear hospital gowns, but rather are expected to bring comfortable clothes - sweats, shorts, etc. - that they wear during the day.
- Students follow an aggressive daily schedule that begins at 6 o'clock the morning after surgery on a unit devoted only to individuals having joint replacement surgery.
- Each day, students receive a daily newsletter with their breakfast - Kneed to Know or Hip Tips, depending on their surgery -, letting them know what is on the agenda for the day, along with providing tips on how to care for themselves.
- Two group therapy sessions are held daily - one in the morning, and a second in the afternoon - in a large room located on the unit. Group therapy is supplemented by individual in-room sessions.
- Group lunches with fellow students and staff also take place on the unit.
- Motivational posters are located throughout the halls, and provide a guide for students to measure their success.
- Students compete with one another on distance walked each day. All progress is tracked on a large exercise board named Steps to Success on the wall in a common area. This exercise board provides visual reinforcement of goals met each day. Students find the camaraderie both challenging and rewarding.
- Care continues after discharge or graduation. Graduates receive calls from the Orthopedic Institute staff within 72 hours of discharge, and again one-to-two weeks later.
- Reunions for graduates and their coaches are held quarterly with surgeons and their entire team.
The End Result: Superior Outcomes
The result of this new approach to surgery is less pain, quicker recovery, and superior outcomes, according to national best practice studies.
"We evaluate each patient on multiple clinical, functional, and patient satisfaction criteria," explained Louis J. Panza, MVH's president and CEO. "These outcomes are then analyzed during monthly performance improvement team meetings, and enable MVH to become masters of teamwork. So, when we say we offer superior outcomes, we will have the data to prove it."
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