John Muir Cuts Post-Surgical Issues
John Muir Health was able to reduce complications in its hip and knee replacement patients by nearly a third by employing a straightforward perioperative patient evaluation.
The two-hospital system in Walnut Creek examined the post-surgical experiences of about 700 patients who underwent hip and knee replacement procedures. They had been evaluated by a nurse practitioner for potential surgical risk factors at a pre-operation clinic. Such factors include reactions to medications and other potentially ovelooked pre-existing physical conditions prior to the surgery.
According to Doug Lange, M.D., a John Muir orthopedic surgeon, “complications range from simple urinary tract infections to heart attacks, serious infections and death. The toll in patient suffering is staggering as is the necessary cost to the healthcare system.”
Hospitals tend to benefit from post-surgical complications: A recently published study in the Journal of the American Medical Association concluded that the average margin for the facility increases 190%. However, the costs are often passed on to insurers and patients. Moreover, patients are hospitalized longer as the result of post-surgical complications.
Several peer-reviewed studies suggest that the mortality rate for hip replacements: Between 1% and 2.5%, higher than those undergoing many heart byass procedures.
Joint replacement patients also have higher rates of long-term post-surgical complications, such as dislocation and metallosis – the discharge of metal particles into other parts of the body.
Yet as a result of John Muir's evaluations, the rate of post-surgical complications rate were reduced from 12.4% to 8.4% when compared to a cohort of patients who underwent knee or hip replacements prior to the opening of the clinic. That is a drop of 32%.
The findings were presented at the recent annual Society for Perioperative Assessment and Quality Improvement Conference in Florida.
“Our work is supported by national trends in the emerging science of perioperative medicine, where there has been a tremendous surge in new information on
ow to better evaluate and enhance quality of care for patients,” said Dawn Knight, John Muir's senior vice president of quality.
The pre-operative evaluation program will soon be expanded to cover other surgical patients, John Muir officials said.
