“Here I am going out in public and people say didn’t you just get a knee replaced,” Trapp said.
Due to his age (57), physical condition and support at home, he qualified for same-day joint replacement surgery provided through Carle Home Health and Carle Orthopedics and Sports Medicine. The two services came together for same-day replacements in the wake of the COVID-19 virus stopping overnight hospital stays for elective surgeries last year.
Medical staff discovered out of necessity that they could continue the same-day surgeries for patients with Home Care and Orthopedics working together. From Nov. 16, 2020 through March 12,2021, there were 132 same-day surgeries for knees or hips. Patients left with home care kits and registered nurses would visit the home to drain the knee, dress the knee or hip, make sure patients were taking anti-inflammatory medication as prescribed as well as provide additional instruction to the patient and home support person. Five Carle nurses even volunteered to set up home visits and cover the first two weeks of transitiion if Home Care resources were not available.
“Once we launched the outpatient plan, many doctors said they will continue with it. The willingness for these areas to come together is amazing," said Andrea Burris, RN, supervisor for Orthopedics and Sports Medicine.
Patient Carl Trapp said the experience was quite different from his first knee replacement when he stayed overnight in the hospital. Following the second knee replacement March 2, a Home Care nurse came to his home the next day, he did in-home physical therapy for three sessions and then twice-a-week outpatient physical therapy for three weeks. With the second knee he used a walker for just three days.
Trapp returned to his job in plant maintenance on April 12. “The strength and stability of these knees allows me to do my job,” Trapp said.
Trapp’s surgeon, Erick Kawakita, MD, said “Covid concerns accelerated the trend toward safe same day discharges for a joint replacements but its important to recognize that a joint replacement is still a big surgery that requires months of physical therapy and time for full improvement.”
Age, height, weight and body mass index, home support, pre-operative mobility and the overall health of the patient are all factors weighed by physicians along with the anxiety level of each patient.
“Historically patients have spent less and less time in the hospital for joint replacement. For same-day surgery, patient education is crucial, Kawakita said. “If a patient meets the criteria and is willing to do same-day surgery, the flexibility is good for them.”
Categories: Culture of Quality, Redefining Healthcare, Community
Tags: care, home, joint, orthopedics, replacement