Page 21 - Hoag Orthopedic Institute 2018 Outcomes Report

ENHANCED RECOVERY PROGRAM (ERP)
Advances in surgical and anesthetic techniques, combined with other therapeutic best practices, have made rapid recovery and early discharge from the hospital possible. To offer the safest, most patient-centric surgical experience for patients, in 2016 HOI implemented its Enhanced Recovery Program (ERP), sometimes referred
to in the industry as enhanced recovery after surgery (ERAS). Data demonstrated that HOI’s joint replacement patients’ length of stay has decreased over time to the point that they were comfortable, ready and able to return home within 24 hours.
Using conservative, evidence-based approaches, the ERP has proven to be safe and successful and is benefiting a growing number of HOI’s orthopedic patients. Prior to scheduling, a physician or trained practitioner recommends the ERP program to patients who meet strict program criteria. Patients with less chronic medical conditions and better functionality are stronger 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 first 72 hours post-discharge.
ERP patients and a “buddy” must attend a pre- operative education class focusing on nutrition, functional mobility and pain control to prepare them for surgery and recovery. Lessons learned through development of the ERP program from anesthetic and rehabilitative standpoints have also benefited HOI’s standard recovery patients.
See also: Patient Stories of Greg Faust, page 56, and Jack Murphy, page 59.
CARE COUNTS
119% ERP VOLUME INCREASE FROM
FY 2016 TO FY 2017
<1% ERP READMISSION RATE CONSISTENTLY
LOWER (BETTER) THAN NATIONAL RATE
99%
OF PATIENTS DISCHARGED TO HOME RECEIVED FOLLOW-UP PHONE CALLS
POST-DISCHARGE PHONE FOLLOW-UP
Having an RN check on the patient’s condition troubleshoots post-discharge health problems, improves future patient experiences, and provides reassurances to post-operative patients. In 2017, to ensure timely communication and reduce post- operative complications, HOI reinvigorated its discharge phone call resources. Additional RNs received training last year in comprehensive, over-the-phone assessments.
Enhanced Recovery Program patients with expedited stays are called within a 24-hour timeframe, and all other patients within 72 hours of discharge.
2018 OUTCOMES REPORT | 18