Joint Replacement Program Gives Good Care, Better Outcomes

Joint pain, primarily from arthritis, affects thousands of adults across the country. According to the American Academy of Orthopaedic Surgeons, 454,652 total knee replacements were performed in 2004, and in the same year, add to that number 232,857 total hip replacements, 41,934 total shoulder replacements, and 12,055 other joint replacements.

Started in 2005, the Total Joint Replacement Program is an all-inclusive program for patients having total hip, total knee, or total shoulder replacement. Once a patient enters the program, he or she receives step-by-step guidance throughout the procedure—from preadmission, to the admission office and stay, and after outpatient discharge and therapy.

The program is offered at Johnson City Medical Center, Indian Path Medical Center in Kingsport, and Johnston Memorial Hospital in Abingdon, Virginia. The only qualification for the entering is a need for total joint replacement. There is no charge for participating.

Patients learn about the program either through community education, such as hip and knee pain classes, or through their orthopedist's office, where the patient is given a guidebook and watches a video in office. He or she is then referred to the coordinator's office for a 90-minute preoperative class. The patient is also instructed on starting an exercise routine before the surgery.

Once admitted to the hospital for surgery, the process is streamlined, with standardized care protocols. Patients typically stay for three days, and then they are discharged to their outpatient home and outpatient therapy.

"The quality measures that we have in place within the program, such as timely antibiotics administration, are being met 100%," shared Spano. "In turn, we have decreased infection and decreased blood clots, huge improvements in patient care.

"I can't stress enough the comprehensiveness of this program. Our outcomes are just amazing. Before we had it, 80 percent of our patients used to go to a skilled nursing or rehab-type setting. We have flipped those numbers; now 80 to 85% of our patients go home, which also decreases infection rate."

"Patients are directly admitted to their room before the surgery, and we try to make it as much like a hotel experience as possible.