several years ago. "We're well positioned as surgery evolves and more
complex procedures move to the outpatient arena," says David Uba,
MBA, Excelsior's CEO. "Now's the time to prepare your facility for
tremendous future growth in joint replacements. If you're not proactive,
you'll be left behind."
Clinical considerations
Orthopedic surgeon Andrew Stoeckl, MD, president of Excelsior's
board of directors, backed the shift from inpatient to outpatient from
the clinical side. He specialized in knee replacement at the local hos-
pital for years before wondering if the procedures could be performed
safely and effectively in the surgery center, and challenged the busi-
ness office and clinical staff to help him make it happen.
It was a gradual evolution. Dr. Stoeckl saw a select group of patients
in the hospital who did really well post-op day 1, leading him to weigh
the possibility of pushing the envelope to shift the procedures to the
outpatient setting.
He says patient selection is the first and most critical clinical consid-
eration. Identify patients who are prime candidates for outpatient pro-
cedures by assess-
ing their medical
comorbidities, level
of family support at
home and pre-op
narcotic use (they
should be narcotic
naïve).
"Once you figure
out patient selec-
tion criteria,
J A N U A R Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 9
Learn how to add outpatient total joints
during a special workshop run by
Excelsior Orthopaedics at OR Excellence,
which will be held October 11-14, 2016
at the Hyatt Regency Coconut Point in
Bonita Springs, Fla. Register at www.orexcellence.com.
How to Build a World-Class
Outpatient Total Joints Program
