Getting joint replacements patients in and out of the hospital swiftly is good for the patients and good for Kaiser Permanente--but is a major departure from past practice. See how this unit-based team stepped up to address staff concerns and keep morale high.
The new goal was dramatic: Reduce hospital stays to 23 hours for total joint patients.
Renee Portillo, RN, was worried.
“It was a shocker. Our staff was used to patients going home in two to three days,” says Portillo, former assistant clinical director and management co-lead of the 7 South medical-surgical team at Fontana Medical Center in Southern California.
The accelerated time frame meant that the unit’s nurses, who care for total joint patients following surgery, would have less time to prepare them for discharge. They’d also need to help choreograph care across multiple departments—Orthopedics, the operating room, Physical Therapy, Home Health—from pre-admission to discharge.
Who best to help the team through this change? The team itself.
“We used our UBT to help change the culture,” Portillo says.
“We helped our nurses be successful by having them anticipate patients’ needs and prepare them for discharge,” says Enrique Rivero, RN, a surgical nurse and UNAC/UHCP member who is the team’s union co-lead.
Fontana is among a growing number of hospitals across the United States to offer a combination of shorter hospital stays and more outpatient care for hip and knee replacement patients. The trend is driven by less-invasive surgical techniques, improved pain management and rehabilitation practices, and patients’ desire to return home as soon as possible.
“There were a lot of challenges. A lot of it had to do with bringing people together,” says Mary Hurley, MD, chief of Orthopedics, who championed the new approach. “They all had to buy in and be willing to support this in order to have a successful program.”
The new approach, which Fontana introduced in January 2014 after months of researching best practices, gets patients walking within hours of surgery and enables them to recover within the comfort of their own homes. The initiative takes advantage of Kaiser Permanente’s integrated model of care and is designed to improve clinical outcomes and reduce costly hospital stays.
Shorter hospital stays for joint-replacement patients helps to:
It also gets patients where they want to be—home.
Watch how this UBT got together to make it work.
Format:
PPT
Size:
1 Slide
Intended audience:
LMP employees, UBT consultants, improvement advisers
Best used:
This PowerPoint slide features an optical team that lowered glasses redo rates. Use in presentations to show some of the methods used and the measurable results being achieved by unit-based teams across Kaiser Permanente.
Format:
PPT
Size:
1 Slide
Intended audience:
LMP staff, UBT consultants, improvement advisers
Best used:
This poster features a Fontana UBT in which 95 percent of members have taken KP's health assessment. Use in presentations to show some of the methods used and the measurable results being achieved by unit-based teams across Kaiser Permanente.
