Joint Replacement Program

Home > Medical Services > Orthopaedics > Joint Replacement Program > Overview

St. John's offers a comprehensive interdisciplinary team for our joint replacement program patients. Since 1995 our joint replacement program has continued to provide the best care in the region for hip and knee replacements. Our team of orthopaedic surgeons, nurses, social workers, occupational and physical therapists, clinical nutrition, home health, and pastoral care provide nationally recognized care and outcomes for our patients. We follow critical pathway for total hip and total knee replacements. Team members develop goals and plans of care for their respective disciplines to span the expected treatment period. The care plan provides a step-by-step patient focused guide beginning with pre-admission education, and serves as a teaching tool for patients and families. The total joint replacement program has a full-time orthopaedic care coordinator who is responsible for implementation, oversight, and coordination of all aspects of the program.

The program is divided into three phases:

  • Pre-operative
  • Operative
  • Post-operative

Pre-operative Phase

The care coordinator contacts each patient when the referral is sent form the orthopaedic surgeons office. A book explaining the program, a questionnaire and detailed map are mailed to each patient. All patients undergoing joint replacement surgery at St. John's attend the joint replacement class prior to their surgery. After the patient completes the pre-admission process and is evaluated, the patient is brought to the physical therapy gym by one of the volunteers who assist with the class. We encourage family or friends who will be caregivers at discharge to accompany the patient to the class. The class participants are seen by the entire interdisciplinary team and are given one-on-one time with each member.

The goals of the team members are:

  1. Physical Therapy: Pre-operative and post-operative instruction and evaluation on exercise, mobility training and restoration of walking skills.
  2. Occupational Therapy: Instructs patients and family in activities of daily living and precautions associated with their joint surgery. Activities of daily living and equipment are demonstrated including; bathing, dressing, bathroom transfers, and transportation home. We encourage our patients to bring loose comfortable clothing as well as a good pair of shoes with the goal of having them dressed and ready for therapy each day.
  3. Clinical Nutrition: Evaluates nutrition problems and follows patients as needed.
  4. Pastoral Care: Advance care planning, as well as emotional and spiritual care.
  5. Social Work: Each patient is evaluated pre-operatively for all their discharge needs. Equipment needs will be addressed at the class. A discharge plan is in place before the patient is admitted to the hospital. Financial counseling is also available.
  6. Nursing: The orthopaedic care coordinator sees each patient in the joint replacement class and throughout the continuum of care. A daily plan of care is included in the book and given to each patient in the class. The orthopaedic floor is staffed with trained orthopaedic nurses who follow the same plan of care established during the class. The patient is encouraged to call the care coordinator with any questions or concerns during the hospital stay and after discharge. We feel it is important to have an accountable person that the patient can depend on to carry out their plan of care. Patients who understand and are knowledgeable about the entire process have faster recoveries with fewer problems.

 

Operative Phase

During the hospital stay, each member of the joint replacement team visits the patient daily. It is important to the patients and members of the team that the plan of care given to the patient is followed. The orthopaedic nurses follow the care pathway and reinforce the information given to the patient. It is comforting to both the patient and families that the information is consistent.

Post-Operative Phase

A large majority of our joint replacement patients return home. Home health physical therapy with nursing visits are ordered at discharge. Effective patient education encourages patients and their families to be actively involved in their health care. Identifying and addressing their needs and fears pre-operatively gives control back to the patient and optimizes patient rehabilitation.

We all have a common goal… to relieve pain and return our patients to an active pain-free lifestyle.