Back on their feet

Patients are getting back on their feet faster and home sooner following hip and knee surgery at Rockyview General Hospital, thanks to an ongoing pilot project.

The Joint Optimization and Incentive Project, launched in August 2009, co-ordinates existing resources to improve access and outcomes for patients requiring hip and knee surgery at the Calgary hospital.

“We have made some really big improvements,” says Tracy Wasylak, co-chair of the Bone and Joint Clinical Network of Alberta Health Services.

Among the improvements:

• When the project started, 47 per cent of patients at the Rockyview were mobile on the day of their surgery. Today, that number has jumped to more than 75 per cent.
• Hospital length of stay has been reduced from 5.5 days to 4.5 days. The goal is 4.0 days when the project ends in August 2010. Even a four- or six-hour difference in hospital length of stay can save hundreds of hospital beds every year for patients who need them.
• Wait times for referral to surgery have been reduced by 55 per cent and are expected to fall further as the project moves along.

“We have been able to implement the provincial care pathway for hips and knees and now have a way to continue to improve on it,” says Wasylak.

“In this project, we found a method that does that.”

A baseline “scorecard” was established at the start of the project and quarterly reports show the progress of the team, which includes nurses, physiotherapists, central intake clinic staff and hospital administration.

Dr. Jason Werle, physician lead for the project, says the team also brainstormed strategies to boost its scores by improving compliance to the care path, improving access and safety, maintaining quality and becoming more efficient.

“We have all the caregivers, who normally work in their silos, beginning to work together. It’s a more co-ordinated team effort for the patient, which is great,” says the orthopedic surgeon.

“All of the different players are more integrated. A lot of it has just been communication – communication between the clinic and operating room and booking; communication between the clinic and the ward and between the ward and rehab.”

Adds Wasylak: “It really shows how every individual on the team makes a difference.”

This method has been so successful, Wasylak says she is hoping to adapt it for use across the Bone and Joint Clinical Network.

More than 900 hip and knee surgeries are performed at Rockyview every year; that represents about 10 per cent of all hip and knee surgeries performed in the province.

Rockyview’s project is one of many initiatives occurring across the province designed to reduce wait times for surgery.

Alberta Health Services aims to reduce the wait time for all elective surgical procedures to 18 weeks by 2015, according to the organization’s performance measures.