recovery, such as a patient's body-mass index, medications, pets, or
even the weather. They can help to develop workarounds and report
the patient's level of complication risk back to the physician ahead of
the surgery.
• Daily and in-depth. Patients who have been cleared for outpatient
joint replacement surgery tend to be healthier patients. On average,
the ones we've seen are about 57 years old. But that doesn't mean
they won't require the thoroughness of care that inpatient joint
patients receive. On the first day of home recovery, our nurses visit
twice, once with the physical therapist and once to check in later in
the day. After that, both nurse and therapist visit once a day, at differ-
ent times, staggering the care to emulate that of a hospital stay.
In addition to administering the physician's prescribed care path-
ways, our nurses are also collecting data: daily pain scores, whether
the patient is constipated or nauseated, the existence of edema. The
physical therapists are rating joint function, range of motion and the
use of mobility assist devices. These "scorecards" are reported back
to the physician, the surgical facility and insurers. Also, the availabili-
ty of electronic monitoring devices means that an attention to detail
doesn't have to wait for a scheduled visit from the caregiver.
Results to report
Physicians from all over are intrigued by Dr. Cherry's and Dr.
McClellan's same-day joint outcomes. They're the result of a four-part
collaboration among anesthesia and their regional cocktail, which
stays ahead of the pain; surgeons and their skilled approaches to the
hips and knees; advanced implant and instrument technology; and
home recovery efforts, which the physicians have credited as a game-
changer.
Consider this: over a 2-year period, their outpatient joint patients
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