Renovated Orthopedic Department Looks Good and Delivers Positive Outcomes

Holy Spirit’s newly renovated orthopedic unit is a well-kept secret that is meant to be shared far and wide, according to William Polacheck, M.D. The hospital’s Chief of Orthopedics wants the community to know that the sixth floor dedicated unit offers private rooms, boasts low rates of infection and re-admission, and provides a comprehensive pain management program that uses less narcotics, while delivering more comfort and fewer complications.“Holy Spirit’s orthopedic unit is a beautiful facility,” he says. “They have done a lot to improve the patient experience, including providing dedicated orthopedic nursing.”The 23 patient rooms (most are private) are spacious, bright and feature large windows, private bathrooms, and 32-inch flat screen TVs.“The rooms are large enough to accommodate orthopedic equipment and visitors and still allow for the patient to move around easily,” says Jynae Foulk, RN, MSN, CLNC, Orthopedic Service Line Manager.Possibly more important than the renovated unit, are the Orthopedic department’s low infection rates. In 2008 the rate of infection for both total knee and total hip procedures was about one for every 100 procedures performed.“Our numbers in Orthopedics have been great for years and nobody knows that,” says Dr. Polacheck. “We need to get it out in the community that our [infection] rates are excellent by any standards.”The department’s successes began with an experienced team of physicians, including surgeons and anesthesiologists, who have practiced with Holy Spirit for many years. Jesse Hoover, MD, whose anesthesia group provides comprehensive pain management, meets with patients prior to surgery and explains their options for anesthesia, including the use of different anesthesia techniques and medications, which make a tremendous difference in both post operative pain and nausea.“We focus on anesthesia from many directions,” says Dr. Hoover. “Instead of relying on a large amount of one drug, we give smaller amounts of several drugs that work together to provide greater pain control and less post operative nausea, which is something patients really appreciate.”The department also offers an optional educational program known as the Total Joint Experience. The class is led by Nancy Hoffman, RN, who walks patients through everything they can expect with joint replacement surgery, prior to entering the hospital.“The nurse leading the class discusses routine procedures, pain control, equipment, even what to expect from a nursing assessment,” explains Lisa Lewis, MSN, RN, NEA-BC, Vice President, Patient Care Services. “The session makes it possible for patients to prepare things at home prior to surgery and think about what will help them with the healing process.”They also view a video that features Holy Spirit therapists discussing the role physical and occupational therapy will play in their recovery. The video also helps to relieve anxiety prior to surgery, according to Chris Bodle, MSPT,Clinical Manager of Inpatient Therapy Services.“Many times, the patients will see the same face [in the video] that they will see after surgery,” he says. “They know what to expect and folks seem to progress better.”
“We do a lot of procedures where we go through the abdomen to the front of the lumbar spine and then turn the patient and do a reconstruction on the back of the spine,” explains Dr. Wolf.
That continuity of care also is prevalent in the therapy services provided after surgery, both at thebedside and in the satellite clinic on the orthopedic floor. The therapy staff rotates every eight weeksthrough the satellite clinic.“We get good continuity of care and develop relationships with the physicians,” adds Bodle.Patients who undergo joint replacement surgery receive physical therapy twice a day, seven days a week. Care begins at the bedside, but as soon as appropriate, the patient moves to the clinic to work on activities such as stairs and balance exercises.“The occupational therapists work with patients in the satellite clinic as well,” he adds. “There the patients can simulate their home routine.”Seeing total joint replacement patients every day means function improves more quickly and patients return home sooner, according to Bodle.“Once a patient is sent home, Comfort Care Home Health picks up the care until they progress to where we can see them in one of our many outpatient rehab clinics in the community.”All of the Orthopedic services and amenities came out of the work of an advisory committee formed to increase communication between hospital administration, orthopedic surgeons, nursing, therapy and other clinicians.“It gives us very strong clinical and administrative collaboration,” explains Lewis. “It really is an interdisciplinary way to look at the quality and outcomes of our program and continually improve.”