A Hartlepool health team who give patients hip and knee replacement surgery as a day-case procedure have been recognised at an awards event – more than two years after it first launched.
The service at the University Hospital of Hartlepool won an award (best poster prize) at North Tees and Hartlepool NHS Foundation Trust’s ‘celebrating excellence’ event, which highlights areas of outstanding practice across the organisation.
Consultant orthopaedic surgeon Manju Ramappa, who set up this service, said: “This was a fantastic achievement receiving recognition at the ‘Celebrating Excellence 2023’ event.
“We have seen some significantly positive changes in the staff mindset and working culture at Hartlepool, since introducing day-case joint replacement.
“Four years ago, the earliest a patient would be discharged is the second day after surgery.
“Currently, excluding our day-case patients, the earliest patients are being discharged is day one after surgery. I call this – ‘the day-case arthroplasty effect’.”
“The average length of stay for all inpatients having hip and knee replacements in Hartlepool has reduced from 3.2 days in 2019 to 2.3 days now.
“The main advantage for patients is early mobilisation and its associated benefits.”
Staff are more confident
Helen Ward, senior physiotherapist, said: “Staff are more confident in the idea of patients being able to leave hospital earlier after surgery, there has been a clear change in mindset.
“We have also seen patients grow in confidence. Patients are seeing and hearing about other patients having a really positive experience by leaving hospital earlier and want to do the same.
“The team has visited other health trusts to learn more and everyone has worked together to make it a clear success.”
Patients are also given the support of the Trust’s homeward team who ensure patients have full support both before and after surgery at home. The team ring them 24 hours after surgery to check on them and offer a 24/7 helpline number answered by one of the arthroplasty ward nurses.
Leeann Thomson, joint replacement specialist nurse for the homeward team, said: “Following the introduction of day-case, the homeward team have found education plays a crucial part in early discharge.
“From the day patients are listed, they are invited to a group education class informing them all what to expect from the surgery both pre-op and post-op, pain management, and given easy access contact numbers for the team if support is needed on discharge.
“We have found that support from the early stages has had a positive impact on the patients expectations, resulting in early discharge which in turn has reduced the average length of stay.”
Emma McCann, advanced nurse practitioner, said: “Lots of hard work, planning and commitment has been demonstrated by the elective care team at Hartlepool.
“Using a multimodal, evidence-based approach our day case protocol promotes fast recovery by limiting the induced stress of surgery and optimising physiological function.
“The patient is involved in their elective journey and with the teams support promoting their own health to aid a successful recovery. Patients benefit from fewer complications, better patient satisfaction and improved functional outcome.”