Page 24 - Hoag Orthopedic Institute 2017 Outcomes Report
P. 24

PERFORMANCE IMPROVEMENT CONTINUED
ENHANCED RECOVERY PROGRAM (ERP) / ENHANCED RECOVERY AFTER SURGERY (ERAS)
The following section features Steven L. Barnett, MD, interviewing Leighton J. Smith, MD, and
Klane Hales, MD (see photo caption for titles).
Pictured left to right: anesthesiologist and Co-medical Director of Anesthesiology Klane Hales, MD; orthopedic surgeon and Chief of Staff Steven L. Barnett, MD; and anesthesiologist, Co-medical Director of Anesthesiology and Chief of Staff-Elect Leighton J. Smith, MD
The ERP was methodically instituted and is being carefully expanded to ensure patient safety and program success.
What factors drove the development and implementation of the ERP?
We wanted to offer the safest, most patient- centric surgical experience for our patients, which culminated in the ERP. The ERP began as a patient-driven initiative, as many of our patients had been asking if they could go
home on the same day as their procedures. Advances in surgical and anesthetic techniques, combined with other therapeutic best practices, have made rapid recovery and discharge from the hospital possible. We have found that our joint replacement patients’ length of stay have decreased over time to the point that they were comfortable for discharge within 23 hours, and often on the day of surgery.
What is the criteria to be considered a patient for this program?
Patients with fewer medical conditions and optimal functionality are strong candidates. Contraindications include unstable or poorly controlled chronic disease, a high BMI, poor ambulation, a mental health condition, or lack of someone to care for them in the  rst 72 hours post-discharge. ERP patients and a “buddy” must attend a pre-op education class focusing on nutrition, functional mobility and pain control to prepare them for surgery and recovery.
400
300
200
100
04 June 2015
156
FY 2016
>360
Projected for FY 2017
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