Page 25 - Hoag Orthopedic Institute 2017 Outcomes Report

“THE MORE TIME INVESTED IN THE PATIENT BEFORE SURGERY, THE BETTER THE RESULTS AFTER SURGERY.”
LEIGHTON J. SMITH, MD; ANESTHESIOLOGIST, CO-MEDICAL DIRECTOR OF ANESTHESIOLOGY AND CHIEF OF STAFF-ELECT
Were there any concerns about discharging patients on the same day?
Our initial concern was that patients may have pain or adverse events away from the hospital. Thankfully, that has not been an issue due to our conservative, evidence-based approach, which has proven to be safe and successful. Proper patient selection has been the key to our success.
How has the ERP impacted patient satisfaction?
Those who had a joint replacement as part of ERP report greater satisfaction. This is supported by the many patients who came back to have a second joint replacement. In the past, they had stayed one or two nights in the hospital.
What lessons have you learned now that the program is up and running?
By selecting the appropriate patients, providing comprehensive preoperative education, setting appropriate expectations and thoroughly preparing the home before surgery, patients can rapidly go home safely. The more time invested in the patient before surgery, the better the results after surgery.
Lessons learned through development of ERP from anesthetic and rehabilitative standpoints have bene ted our standard recovery patients as well.
Do you foresee the ERP patient volume increasing as a result of your early experience?
De nitely. Last year was our rst year to offer
this program and it proved to be a win for all
hip and knee replacement patients, providers collaborating on care, and payers. Using a shared decision approach to provide better-coordinated, high-quality care and reduce the overall cost of treatments, we expect ERP will not only survive these changing times; it will bene t a growing segment of the orthopedic patient population (See chart on page 19.)
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