Staff at Lancashire Teaching Hospitals NHS Foundation Trust have performed their first total hip replacement on a patient who was subsequently safely discharged home on the very same day.
Patients who undergo a total hip replacement used to stay in hospital for 3-5 days but now typically stay in hospital for 1-3 days following this type of procedure; thanks to the work of the multi-disciplinary team at Lancashire Teaching Hospitals. In this instance, the patient was admitted to the ward at 7:14am and was then discharged at 6.50pm that day.
This is the first time that a patient undergoing a total hip replacement has been able to be discharged the same day at Lancashire Teaching Hospitals; thanks to the collaborative efforts of an innovative and dedicated multi-disciplinary team.
Rich Boden, Consultant Orthopaedic Surgeon at Lancashire Teaching Hospitals, performed this operation and says that it was a huge team effort that enabled them to make this massive improvement to the length of stay.
Rich said: “This operation represents the pinnacle of many months of hard work on behalf of the lower limb group, the ward staff, the physiotherapists and the enhanced recovery team. It should be said that this is very much a joint effort from the lower limb surgeons, anaesthetists, the theatre team, ward staff, physiotherapists and the rehab team. Regionally, I believe we are only the second unit to manage this, and nationally, we would be up there with the leaders in enhanced recovery.”
Enhanced recovery is an approach that helps people to recover quicker following major surgery. It aims to ensure that patients are as healthy as possible before receiving treatment, receive the best possible care during their operation, and receive the best possible care while recovering. Enhanced recovery programmes try to get people back to full health as quickly as possible.
Patients undergoing enhanced recovery will be advised on things to consider prior to the operation such as eating well and relaxation, as well as what to do in hospital to make recovery easier such as staying active and drinking clear fluids. After surgery, patients would also access rehabilitation services such as physiotherapy.
Rich continued: “The appointment of our dedicated enhanced recovery practitioner, Amy Crossley, was fundamental as it allowed new processes to be put in place. The protocols, procedures and plans we have put in place have seen our overall length of stay drop to the shortest regionally. We have also been discharging partial knee replacement on day of surgery for some time now. As a team, we are really pleased that we are now able to reduce the length of stay for patients undergoing partial knee and total hip replacements which will massively benefit their experiences and recovery.”
Amy Crossley, Enhanced Recovery Practitioner at Lancashire Teaching Hospitals, said: “My role is to create a seamless liaison between the ward, theatres, recovery and discharge. I ‘meet and greet’ all lower limb arthroplasty patients admitted to the ward and reinforce messages given to them in outpatient clinic, pre-op clinic and the joint classes, given by the therapy and rehab team. I am able to introduce myself, answer any questions and give a level of personal care to the patient.”
Amy works closely with the patients to identify the best individual care plan for them to help them through the operation and on their road to recovery. Once the patient is on the ward she coordinates care, rehab, x-ray and discharge planning. After discharge, she remains in contact with patients and makes sure all is well.
This new approach is enabling the team to reduce length of stay for patients and improve patient experience through making patients active in their own recovery.