The Center for Joint Health, a dedicated unit for hip and knee joint replacement patients, focuses on the entire patient experience. The goal is to help patients get back to doing the things they enjoyed before being sidelined by joint pain. Patients admitted to this unit are healthy but have knee or hip pain. These patients are motivated to participate in their recovery and get back to an active life, free of pain. The distinctive center allows patients to work together and support each other as they build strength, mobility, and a better quality of life. The Center for Joint Health is located at Community Hospitals East, North and South.
Community Hospital East celebrated its one-year anniversary of the Center for Joint Health in July 2009. Within a short period of time, they achieved and maintained a 97% excellence on follow-up satisfaction surveys. The center has an average ambulation of >1000ft distance walked as compared to 95ft prior to program implementation and has been instrumental in the improvement of HCAHPS scores for the hospital.
Across all sites there are approximately 20 beds. The staffing mix is about 4 to 6 patients per nurse, plus one support person. Shifts available include 8- and 12-hour. Types of nurses in this area include RNs, patient support persons and some LPNs.
Nurses at the Center for Joint Health perform assessment, planning, teaching, treatments, medication administration and pain management, documentation and assistance with activities of daily living (ADLs). Patients at the centers have a mix of diagnoses related to orthopedic/joint health, including joint pain, osteoarthritis, necrosis of the hipstroke, complicated migraines, pneumonia, GI hemorrhage, cerebrovascular accident (CVA), malignant neoplasm of the prostate, osteomyelitis of the foot and acute right humeral fracture/dislocation. Patients served are adults with an average age of 66.
Types of equipment used in the centers include IV poles, pumps, feeding pumps, walkers, exercise recliners, sequential compression devices (SCDs), traction equipment, trapezes, sphygmometer, pulse oximeter, incentive spirometer, bedside commodes and ice packs.
For those nurses who want variety in experience, the joint health unit offers that as well. With a mix of orthopedic patients as well as the medical/surgical population, nurses are able to stay “sharp” in their assessment and hands-on skill sets. Specific cross-training opportunities are available in hip and knee replacement.
What makes this program special?
Staff feel this program is special for many reasons, including the program's focus on wellness within the ortho/surgical population. It is a structured, well-coordinated program for patient's s/p hip and knee replacement. There is a standard order set and treatment protocols that orthopedic surgeons have agreed upon. They do extensive preoperative education for patients and follow patient progress up to 6 months s/p surgery. Patients engage in many activities, e.g., therapy and meals as a group. There is a lot of friendly competition, support, motivation and encouragement within the group.
Staff note that, "We begin every day knowing what we want to accomplish with and for the patient. Prior to the start of the program, the entire multidisciplinary team, including our surgeons, signed an agreed upon philosophy statement that is posted on the wall on our unit. Our activities are purposeful, our practice is goal directed and evidenced-based, and patients are an integral part of the treatment team."
One visitor to the unit wrote, “As a clinical liaison who has not been at CHE to assess a patient until today, I just wanted to express that the staff are great, they really know their patients' needs and the feeling of the environment was clean and welcoming. The difference from where I normally go between Methodist and IU cannot come close to the calming and caring atmosphere this hospital has. Human caring and genuine concern is most definitely noted.”
Exceptional patient experiences
Judy Cornett, joint care coordinator at Community Hospital East notes several exceptional patient experiences:
It is not at all atypical to hear these kinds of comments from our patients: “Do I have to leave?” “This is the best time I have ever had.” One patient wrote, “The personnel is excellent and that is the key to your program. Caring is a commodity that you cannot buy.” Other patients have compared their experience here to experiences they have had following orthopedic surgery in other hospitals. They often cite the preoperative education class and initial preparation for the entire surgical experience and recovery as one of the areas that sets our program apart from their previous experience. In our first month of the program, Dr Egwu did a total hip replacement on a 42-yr-old white female with congenital bilateral hip dysplasia. Within seven weeks of discharge, she returned for total hip replacement on the opposite side. At the reunion luncheon, she tearfully shared how her teenage son had never seen her except in a wheelchair. Now she is one of our weekly volunteers for the program.