June 09, 2022
Summer means more outdoor activities, from hiking and cycling to tennis and golf. For people with joint issues, though, it can mean disappointment. Whether from an injury or a chronic condition, joint issues can require surgery or even full replacement of a hip or knee.
That kind of major surgery can be an unsettling prospect, with many patients worried about pain or long recovery. That’s what led Good Samaritan Hospital to rethink its entire orthopedic surgery approach and build a new department with a different kind of patient-centric focus.
Adopting a model developed in Maryland by renowned orthopedic surgeon Dr. Marshall Steele, the hospital’s orthopedic center is based on providing a complete and positive patient experience that starts long before the surgery itself and continues through the patient’s recovery.
“It’s a real paradigm shift in care,” said Daniel Mendoza, the hospital’s Orthopedic Service Line Coordinator. “We promote independence for the patient. About 90% of our patients are up and walking hours after surgery.”
The main goals of the program are to reduce the length of stay, reduce blood transfusions, and reduce any complications that might require a patient to return to the hospital.
Good Samaritan Hospital has built a complete orthopedic center aligned with that philosophy, which begins with education and care coordination. Each patient has a single point of contact – Mendoza – who works with them from the outset. Patients are made an integral part of their treatment – they attend a virtual pre-op class two to three weeks before their surgery, and they are given an 82-page notebook with information about the procedure as well as post-operative care.
“It’s a pretty self-sustaining system that covers all facets of recovery,” said Dr. Daljeet Sagoo, Medical Director, Silicon Valley Joint Replacement Center. “Patients are more informed, and recovery is quicker.”
The patient experience includes the crucial area of pain management, which can make the difference between a patient recovering quickly or not. That starts with the surgery itself, which often is done using sophisticated spinal nerve blocks that minimize the need for narcotics in anesthesia. The same approach applies to post-operative pain management, which also emphasizes minimal or no narcotics or IV pain medication that would require patients remain connected to a machine.
“We’re attacking pain on multiple fronts, which starts with surgeons talking to patients and setting expectations, letting patients know that some pain and discomfort is normal,” Dr. Sagoo said. “The term I like to use is multi-modal. We don’t say you’ll be walking out of the hospital pain free, but knowing that’s temporary is an important first step. And that has really accelerated patient satisfaction and recovery time.”
Mendoza called this pain management approach “the cornerstone” to better patient outcomes – and notes that while there is post-surgical discomfort, most of the center’s patients have lived with chronic pain for years, even decades.
Another factor in the patient experience is the team approach to care, which includes a core group of professionals who have worked together for many years.
“It’s a total team effort, and we have a pretty tight-knit group here, from the nursing staff to the administration,” Dr. Sagoo said. In addition, the team is constantly improving its knowledge, from attending conferences to staying on top of the latest research and scientific data.
“So many patients jump to the Internet looking for a solution, but your body is going to tell you when you’re ready for surgery,” Mendoza said. “And at that point you need to work with a credible orthopedic surgeon.” That means someone who performs at least 50 replacements a year and will have a strategic plan for the patient – which is at the heart of Good Samaritan’s approach.
“When I was doing my residency 10 years ago, we didn’t have anything like this,” said Dr. Sagoo. “You can just see the comfort among the patients.”