Rhonda Smith, RN and the complete “Joint Camp” team are deserving of this honor because of the excellent educational program for patients prior to joint replacement surgery. Rhonda, the Nurse Educator for Central Louisiana Surgical Hospital, developed a joint camp to provide preoperative education and preparation for total joint replacement patients. The camp was designed to prepare the patients for the surgical experience and includes communication from the following specialties: Nursing, Anesthesia, Physical Therapy , Respiratory Therapy, Infection Control, Utilization Management and IT (patient portal). The camp sessions are scheduled routinely to provide access for most patients. The presentations last about 2 hrs and questions related to all parts of the surgical experience, from insurance to clinical care are answered. Patients who attend the camp are extremely satisfied and verbalize “The camp was the best thing” to prepare us for surgery.
Rhonda Smith, RN developed the camp in collaboration with the orthopedic surgeons to get precise information on the procedures to validate program data. She was able to gain the support of all the orthopedic surgeons and got their approval of all data included in the program. The program design includes patient engagement and communication. The patients are contacted after case scheduling and encouraged to attend and bring a family member with them so they can hear the instructions and assist the patient as needed. The camp program is presented in a very relaxed atmosphere with snacks served and questions are encouraged.Topics covered in the camp include:
1. Patient portal
2. Anatomy and physiology of knee/hip and basic steps for proposed procedure
3. Types of anesthesia
4. Respiratory care postoperatively
5. Pain management
6. Possible complications
7. Infection control
8. Discharge planning
9. Frequently asked questions
The camp covers “things to do before surgery” to help them prepare and plan for, things like insurance issues, what medications to stop, importance of not smoking, and discharge planning prior to surgery. Home preparation is covered extensively including modifying bathroom, where to place items, and trip/fall hazards to avoid injury after discharge. Specific attention is given to the night before and day of surgery for infection control measures and arrival time and important items to bring to the hospital. The physical therapist information includes exercises before and after the surgery to achieve optimal outcomes. The infection control practitioner gives extensive information on preoperative and post operative infection prevention measures as well as basic hygiene measures. We are fortunate to have anesthesiologists who give their time to the camp and cover anesthesia choices, techniques and pain control postoperatively.
The prospective patients are given a tour of the Inpatient Unit to introduce them to the surroundings they will see after their surgery.
The attendees at the joint camp complete an evaluation of the overall program at the end of the camp session. The following survey results for 2014 indicate the overall patient satisfaction with the joint camp design:
1. The information presented was helpful – 97%
2. I understand what to expect during my hospitalization- 92%
3. The presenters were knowledgeable about their topic- 94%
4. The location of the camp was convenient–94%
5. The room was comfortable- 94%
6. The refreshments were acceptable- 97%
7. Did you bring a family member- 67%
Additionally there were very positive comments written on the evaluation form.
We do approximately 500 total knee replacements and 150 total hip replacements annually and this represents 90% of our total inpatient volumes. Central Louisiana Surgical Hospital patient satisfaction scores as recorded on Hospital Compare remain very high at 90% for overall rating of hospital experience and 93 % for recommend and definitely would return.
The camp still has opportunities for improvement. The main goal for improvement is to achieve 90% of all first-time joint replacement patients attending a camp session. Our attendance has steadily grown since its inception in December 2013. The attendance rate currently is above 60%.