providers and physical therapists are in constant communication
about each case. They all participate in pain management planning for
each patient, and we are consistently evaluating and improving our
pain management protocols.
Ambulatory surgery centers hold a definite advantage here, because
they're able to handpick teams that routinely work together, as
opposed to hospitals, where there's a higher degree of staff rotation.
The end result is a seamless experience for the patient.
Beyond the clinical team, we ask all of our joint replacement
patients to identify a "coach" among their family or friends. This per-
son should be able to accompany them to their pre-operative visit and
to surgery, help them maintain their physical therapy requirements
after they're discharged, and assist with any mobility or pain manage-
ment concerns in the days after the procedure. We believe that having
a personal resource and advocate is particularly important for
patients following outpatient joint replacement, where home recovery
is convenient but pain management is crucial to rehabilitation.
In addition, we arrange for in-home nursing and physical therapy
before the day of surgery, the same recovery services that patients
would receive during a hospital stay. Typically the nurse and physical
therapist will visit the patient once a day for a week, then scale back
their services as dictated by the patient's progress.
3
Multimodal anesthesia
Without question, your approach to anesthesia will distinguish
the success of your pain management protocol — and by exten-
sion your joint replacement program — from the rest.
If your goal is to facilitate faster patient recoveries and keep post-op
pain in check, a protocol that reduces opioid consumption is key. A
combination of peripheral nerve blocks and peripheral nerve catheters
2 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 6
