Lead author surgeon Richard A. Berger says it's not just the surgeon's skills and techniques that help patients avoid a hospital stay.
"It's a comprehensive management pathway helps the patient avoid an overnight stay. It's optimal sequencing and timing of interventions by the nursing, physical therapy, anesthesia surgical team; it's a team approach of equally weighted preoperative, intraoperative, and postoperative care."
Patients meet with the physical therapist and nurse prior to surgery. "The nurse time is invaluable to patient before going into surgery," says Berger. "They attend a class led by with a nurse where potential surgical complications and postoperative care are discussed.
Patients spend an hour learning about the surgery, asking questions about pain, recovery and surgery. We reassure patients that their pain will be controlled, that they will be carefully monitored for the occurrence of complications or delayed recovery due to early discharge, and explain how will be able to move around independently after surgery.
After class with the nurse, patients have a physical therapy session for instruction in gait training with crutches and a cane. An internist also evaluates patients as part of our hospital's policy. Lastly, the hospital discharge planner calls the patient at home before surgery to make sure all someone can take him or her home after surgery."
The 50 study patients (20 female, 30 males) had surgery between August 2003 and August 2004. The average age was 68 years old, average weight of 203 lbs. with a body mass index of 29.2. Forty-eight of the patients had osteo
Contact: Mary Ann Schultz
Rush University Medical Center