The Good Samaritan Orthopedic Center of Excellence is able to provide outstanding care with optimal patient outcomes by focusing on reducing adverse events after total hip and total knee replacement.
Total Hip and Knee Patient Registry
To track long-term patient outcomes, the Good Samaritan Orthopedic Center of Excellence implemented a Total Hip and Knee Patient Registry in 2011. All patients undergoing primary or revision total hip or knee replacement at Good Samaritan Hospital have the option to provide relevant details about their procedures added to a database that tracks quality outcomes. Individual patient data is available for each patient’s surgeon to review; and non-identified aggregate data for all patients is available for the Center’s physician panel to review. The result is an ongoing examination of quality that identifies opportunities to improve outcomes for all patients. Since the registry’s implementation, quality measures at Good Samaritan have been found to surpass outcomes reported by most centers across the nation. These include:
A surgical site infection after total joint surgery can be a costly and debilitating complication. Through a unique program called “Zero In On Zero,” (PDF) our practices to prevent surgical site infections begin before you are admitted to the hospital and continue after you are discharged home—resulting in a near zero rate of infection. At Good Samaritan, infection rates are well below state and national averages.
Almost all total joint patients experience a drop in red blood cell count after surgery. At Good Samaritan, we screen and treat for preoperative anemia to proactively address the problems leading to anemia after total joint surgery. With the additional use of medical and surgical (best practice) strategies to reduce blood loss, the need for a blood transfusion is almost eliminated. At Good Samaritan, less than 3 percent of patients require a blood transfusion, which is well below national averages of 20 to 25 percent.
Part of this work was the formation of an anemia clinic exclusively for hip and knee replacement patients. The anemia clinic process is hardwired to screen and treat the patient with no extra testing and without interruption of the scheduled total joint surgery. Screening is completed on each patient during the routine pre-admission testing and results are reviewed that day. If the patient is found to be anemic, a pathologist evaluates the blood results and provides the anemia diagnosis. The patient is then seen by a hematologist in the Outpatient Treatment Center where treatment can begin as early as the first visit. Once treatment is complete, patients undergo surgery.
Although patients with osteoarthritis live with pain every day, the fear of pain related to total joint surgery often results in delay of treatment. To promote optimal pain relief, we use several pain control methods before, during and after surgery; working one on one with each patient until a comfort level is reached. Less pain allows you to actively participate in physical therapy; often as early as the day of surgery.
Planning and Preparation
Weeks before surgery, patients are scheduled for an educational session to prepare both the patient and family for the total joint experience. This session allows you to speak to a nurse, a physical therapist and a social worker who will assess your needs, provide information and answer your questions. Your preadmission testing is also completed that day to eliminate multiple trips to the hospital.
Therapy at the Bedside
After surgery, there is no need to leave the nursing unit. A physical therapist will work with you at the bedside to begin your rehabilitation. An occupational therapist will assist you with tips on dressing, bathing and other daily activities to prepare you for independence at home. At Good Samaritan, nearly 80% of patients are discharged to home with either outpatient or home physical therapy.
Our patients are typically ready for discharge within two to three days after surgery and 80 percent of our total joint patients are able to return to the comforts of home. Prior to discharge, the discharge planning team will evaluate your individual needs to ensure a safe transfer home. If more intense rehabilitation is needed, this same team will work with you and your family to facilitate the best outcome. At Good Samaritan, the average length of stay for knee replacement patients is 2.74 days; for hip replacement patients, the average length of stay is 2.53 days.
These quality outcomes are important because patient access to quality care will rise due to patient desire for outcome transparency in health care. Patients are more likely to select total joint arthroplasty (replacement) when they can be assured of optimal recovery, low rates of adverse events, and improved quality of life.
Recognized for Excellence
In addition to The Joint Commission, healthcare payers such as Anthem Blue Cross/Blue Shield, have taken notice of the quality orthopedic care offered by the Good Samaritan Orthopedic Center of Excellence by listing them as an Anthem Blue Distinction Center for Knee and Hip Replacement since 2010.
Good Samaritan is looked upon as a leader in orthopedics within Greater Cincinnati. The physicians from the Good Samaritan Orthopedic Center of Excellence are teaching other physicians from around the world how they can achieve similar results. Nearby hospitals from Bardstown and Lexington, Kentucky; Dayton, Ohio; and even a local Cincinnati hospital has visited Good Samaritan to review the Center of Excellence program and quality initiatives.