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J O I N T
R E P L A C E M E N T
DO'S AND DON'TS
in charge," he says. "I
Keys to a Successful
Outpatient Total Joint Program
know exactly what
Brian Detwiler, CRA, COT
this person needs or
DO
DO establish universal total joint
protocols and patient-selection
criteria.
DON'T
DON'T allow ambiguity in protocols or patient-selection criteria.
DO educate all members of the
DON'T wait to educate after the
perioperative care team, including surgical procedure.
the patient and his support team.
DON'T select patients who aren't
motivated to return home immediately after surgery or who are
unsure their home support systems are adequate.
DON'T screen patients at the last
minute.
DO plan for the procedure.
DON'T change the plan without
Identify all roles and responsibili- full communication within the
ties for patient care throughout
care team.
the planned procedure
DON'T make last-minute changes.
DO assess the care given and the
outcomes of each surgery using
quality assessment/quality
improvement data collection
methods.
exactly what to do if a
problem arises. In a
hospital, other doctors
are seeing my patients
and are more likely to
DO communicate these protocols DON'T assume that all members
and selection criteria to all mem- of the care team know and underbers of the total joint care team. stand these protocols and criteria.
DO screen and select appropriate
surgical candidates well in
advance of the planned procedure. A personal anesthesia consultation is vital to clear all candidates. Select only highly motivated patients with appropriate home
care support systems in place.
doesn't need and
DON'T fail to follow up with each
patient and assess opportunities
for continuous professional
improvement.
— Dave Berkheimer, BSN, CRNA
Mr. Berkheimer (d berk heimer@remca rea nesth esia .com) is president and
CEO of RemCare Anesthesia Solutions in Altoona, Pa.
order unnecessary
tests."
Mr. Berkheimer estimates the cost of joint
replacement surgery in
an ASC is about onethird the cost of an
inpatient procedure.
"When I saw the success of this program,
right away I knew that
it would change the
way health care is provided in orthopedics in
this country," he says.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2013
