Hip or knee replacement can be a very successful experience at Providence Hospital, thanks to “Joints on the Move,” a program that helps patients prepare for and recover from a joint replacement procedure.
Working with the orthopedic health care team at Providence, patients are often able to get back on their feet more quickly and go home sooner. The program is offered without charge to patients scheduled for surgery at Providence who are referred to it by their orthopedic surgeon.
Fredericka Carter, a clinical nurse specialist at Providence, said the goal of the program is for patients to be physically strengthened before hospitalization, which helps improve postoperative recovery time. “We strive for our patients to be doing well enough to be discharged home at approximately three days following surgery,” said Carter.
To enroll in the program, patients should consult with their orthopedic surgeon at least five to six weeks prior to their anticipated surgery date. At this time the physician’s office can schedule both surgery and the required two-hour Joints on the Move preoperative education class. Patients also need to select a “coach” (a family member or friend) that can attend class with them, be available at designated times during the first three days following surgery, and help them with home care.
At the pre-operative class, patients will get an information notebook that gives detailed information about preoperative preparations, care during hospitalization and care at home following discharge. Classes are held at Providence Hospital on Monday afternoons from 2:00 p.m. to 4:00 p.m. The class is taught by a clinical nurse specialist, a respiratory therapist, a clinical dietitian, rehabilitative services staff members and a case manager.
According to Carter, Providence schedules surgery for Joints on the Move patients on Mondays and Tuesdays so they will be ready to go home before the weekend. Following surgery, patients are placed on the Joints on the Move clinical pathway, or plan of care. “The morning after surgery, most of our Joints on the Move patients are up on their feet, with help from the physical therapy staff,” said Debbie Martin, nurse manager of Providence’s orthopedic unit. Martin added that Joints on the Move patients are typically able to walk twenty-five to fifty feet with minimal assistance the day after surgery, which is a significant improvement over traditional total joint replacement cases.
Post-surgical care is individualized for each patient. “We evaluate our patients the morning after surgery, to determine a course of care,” said Carter. On the second and third postoperative days, patients dress in “street clothes” instead of hospital gowns or pajamas, and begin group physical therapy sessions. Coaches participate in the therapy sessions so that they can become comfortable with caring for the patient following discharge.
Once patients are discharged from the hospital, Joints on the Move patients are strongly encouraged to continue outpatient therapy, either at the Providence Rehabilitation and Wellness Center or a similar facility. If the patient does not have transportation available to an outpatient center, home physical therapy may be an option.
Both Carter and Martin said that response to the program from their patients has been “wonderful.” “If you’ve been told you need a total hip or knee replacement, please ask your physician about participating in a preparation program like Joints on the Move,” said Carter. For more information about joint replacement surgery and how to prepare for it, Carter recommends contacting an orthopedic surgeon. Patients who would like the name of an orthopedic surgeon practicing at Providence Hospital can call the hospital’s physician referral line at 251-633-1362.