Using its best-practice methods for infection control and patient care, the Hospital for Special Surgery in
Infection control and length of stay are concerns for any hospital, so when the
As reported in the first issue of the Journal of Arthroplasty this year, data collected during the first 10 months in operation of the South West London Elective Orthopaedic Centre in 2004 showed that the hospital had decreased their infection rates from 1 percent to 0.16 percent and length of stay by an average of five days, from 11 to six days. This decrease was benchmarked against a 2000 national survey by the Royal College of Surgeons of
The waiting time for patients undergoing hip replacement surgery in the United Kingdom was almost a year. The government issued a report in 2003 stating that the time should be decreased to reduce unnecessary pain and suffering, said Thomas P. Sculco, MD, surgeon-in-chief of HSS. The construction of a new hospital for orthopedic procedures was one of the outcomes of the report, and they contacted HSS to incorporate our best practices in their new hospital.
Representatives from Hospital for Special Surgery went to London right at the beginning, as the construction plans were being drawn up. With infection control a huge issue in the
We had the opportunity to go in before the facility was even built, to help them design infection control at every level, said Eileen Finerty, RN, director of nursing for infection control and occupational health at the Hospital for Special Surgery. We were creating a state-of-the-art facility that was focused on infection control and length of stay. At Hospital for Special Surgery, infection control is considered everyones responsibility and it should be maintained at every level from washing hands and having clean equipment to patient placement and traffic patterns for patients, equipment and supplies. The separation of clean and dirty is one of the basic principles of infection control, said Finerty. But hospitals are busy places and busy people take shortcuts. You need to remind them to stop and do the basics.
Controlling infection is one way to shorten length of stay, but HSS also helped the
HSS is all about patient-focused care; the entire staff is trained to help with the patients recovery, said JeMe Cioppa-Mosca, PT, MBA, assistant vice president in the department of rehabilitation at the Hospital for Special Surgery.
A large part of patient coordination starts before the patients are admitted. At a pre-operative class, patients are given a seminar and manual to lead them through every step, from the day before surgery through recovery. The patients and the staff all know beforehand what the expectations are and how the clinical course should progress, continued Cioppa-Mosca. We helped the
The paper, Effectiveness of Best Practice Implementation in Reducing Hip Arthroplasty Length of Stay, shows that the transfer of knowledge was successful after only a few months as was evidenced by reduction in infection rates and length of stay. Since that time, their average length of stay for hip and knee replacement has continued to be one of the best performances in the United Kingdom.
This model demonstrates that best practice transfers are possible and effective, said Sculco. They reduced length of stay to six days, infection rate to 0.16 percent and lowered waiting times for patients. Transfers like this, of ideas and methods that work, have a profound effect on patients lives.
Source: Hospital for Special Surgery