At the 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + Future of Spine June 12, Patrick Toy, MD, a surgeon with Memphis, Tenn.-based Campbell Clinic Orthopaedics explained how clinicians can move their total hip arthroplasties and other total joint surgeries from the hospital to the outpatient setting.
"Patients don't really want to stay in the hospital" after hip surgeries, he said, so performing total hips and other total joint surgeries in an ASC is a more patient-centered approach to the surgeries. It is also a lower cost site of care compared to the hospital.
Dr. Toy broke down the process into the following three areas of focus:
• Organization. The surgery center director should "quarterback" the process of moving total joint surgeries into the ASC. The surgical staff at the ASC is also a concern. Dr. Toy said his staff comes from hospitals and have previous experience with total joints.
• Patient selection. Though performing total joints in ASCs is an option for many patients, it is not right for all patients. When choosing a patient, surgeons should examine the payer source and any underlying medical issues that could complicate the surgery. Also, the patient should be motivated to improve and not "on the fence" about doing the surgery in an outpatient setting. The next step is communication and education. "If you say [to the patient] 'you're going to be ready to walk' they're going to believe you, Dr. Toy said.
• Preparation. Dr. Toy suggested sending patients to "prehab" prior to surgery, where they visit a physical therapist and learn how to use a walker or a cane they will use after the surgery. Additionally, there needs to be a back-up plan in place with a hospital, since total joints can have "more potential issues" than other procedures traditionally performed in ASCs. Dr. Toy also recommended simulating the procedure in a hospital and having staff record everything the surgeon touches, to make sure the ASC has all the necessities for the surgery.
Finally, all that's left to do is execute the plan. He noted clinicians shouldn't have to advertise the service, because good patient experiences "generate more opportunities."
"Patients don't really want to stay in the hospital" after hip surgeries, he said, so performing total hips and other total joint surgeries in an ASC is a more patient-centered approach to the surgeries. It is also a lower cost site of care compared to the hospital.
Dr. Toy broke down the process into the following three areas of focus:
• Organization. The surgery center director should "quarterback" the process of moving total joint surgeries into the ASC. The surgical staff at the ASC is also a concern. Dr. Toy said his staff comes from hospitals and have previous experience with total joints.
• Patient selection. Though performing total joints in ASCs is an option for many patients, it is not right for all patients. When choosing a patient, surgeons should examine the payer source and any underlying medical issues that could complicate the surgery. Also, the patient should be motivated to improve and not "on the fence" about doing the surgery in an outpatient setting. The next step is communication and education. "If you say [to the patient] 'you're going to be ready to walk' they're going to believe you, Dr. Toy said.
• Preparation. Dr. Toy suggested sending patients to "prehab" prior to surgery, where they visit a physical therapist and learn how to use a walker or a cane they will use after the surgery. Additionally, there needs to be a back-up plan in place with a hospital, since total joints can have "more potential issues" than other procedures traditionally performed in ASCs. Dr. Toy also recommended simulating the procedure in a hospital and having staff record everything the surgeon touches, to make sure the ASC has all the necessities for the surgery.
Finally, all that's left to do is execute the plan. He noted clinicians shouldn't have to advertise the service, because good patient experiences "generate more opportunities."