Wednesday, October 5, 2011

Joint Understanding: How Patient Communication Improves Surgery

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My mother recently had knee replacement surgery at Centra Health in Lynchburg, Virginia. Since my blog is intended to be a journey of understanding the individual’s changing role in their healthcare, I thought it was an excellent opportunity to ask my father, Ed S. Lovern, to serve as a guest blogger.

My 72-year-old wife, Pat, had her knee replaced five days ago. Everything about the operation has been just about perfect. As we recalled my completely opposite experience with prostate surgery seven years ago, we wondered why there was such a difference.

We both approached our operations healthy and optimistic, had excellent surgeons and large modern hospitals. The difference was in preparation, communication, and total focus on the patient. And, on her 75-year-old “coach,” me.

Pat’s surgeon, whom we met only a few months ago, has the uncanny ability of almost instantaneously becoming a good friend while simultaneously inspiring absolute confidence. A month before surgery, he gave us a large notebook containing everything we needed to know.

Two weeks later we attended Joint Camp with a dozen other patients and their coaches. A well informed, clear-speaking nurse and her PowerPoint presentation explained everything ahead of us: the mechanics of the operation, how and when to put on support stockings, exercises, schedules, medications, timetables—nothing was left out.

We learned we had reserved Joint Camp parking spaces one minute from the hospital’s front door. (With thousands of cars filling several huge parking lots, the normal walk is 15 minutes.)

Our small Virginia city is blessed with an outstanding hospital system whose administrator has been on the job here for over 30 years. He and his board of business and medical leaders—plus amazing community financial support—have transformed our primary, 50-year-old, 330-bed hospital into a modern, beautiful facility. I’m convinced that its wide curving halls, gardens, and overall beauty is one reason why every employee seems to greet every visitor with a smile and friendly hello—and why patients seem happier and healthier.

Last Tuesday morning, we quickly checked in at 7:30 for the 9:30 operation. In the waiting room I watched Pat’s progress on large, wall-mounted monitors: pre-op, op, post-op, recovery. About 10 a.m. the waiting room “mother” told me the operating room had called to report all was going perfectly.

Our magnificent surgeon appeared, beckoned me into a small room, and told me Pat had done a great job and her new knee was a complete success. Later on, up in her private room, every nurse, therapist, and orderly reiterated his assessment that Pat’s triumph was primarily her doing.

We ordered her room-service lunch from a surprisingly comprehensive menu. Then I returned to the car to carry in a suitcase, two plastic bags, and her walker. As I tried to gather it all up, a young female orderly walked up, told me she was just returning from lunch, and insisted on helping me carry it all up to the room.

The next afternoon and again Thursday morning brought more Joint Camp sessions of training, exercise, and therapy. This time there were only two other knee patients and one with a new hip along with their coaches. Thanks to the skill and gregariousness of our two therapists, we were all friends in minutes.

Surgery may be successful for many reasons. Of course it takes good people and facilities, but I think it’s vital that they all work to minimize the causes of stress via preparation and communication that instill confidence in the patient. And her coach.

Mom continues to recover nicely. Piedmont Healthcare also offers a version of joint camp – called A Joint Effort – for joint replacement patients.

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5 Comments

  1. Pat Lovern
    Posted October 5, 2011 at 9:19 pm | Permalink

    Surgery was 15 days ago and thanks to excellent, extensive physical therapy, I’m walking today without a walker or a cane.

  2. Michael Rovinsky
    Posted October 6, 2011 at 12:51 pm | Permalink

    Wow! Sounds like a true and total focus on the customer (patient) experience. I wonder who else had that focus and changed our lives? Not a bad idea for healthcare too.
    Glad your mother is doing so well!

  3. Posted October 6, 2011 at 3:28 pm | Permalink

    `happy to hear of Ed’s mom’s excellent outcome: another fine example of how an outstanding regional health system can empower and enable “healthcare consumerism.”
    That said, I’d like to pose a politically-incorrect question. And I’ll set it up with a recent cocktail party anecdote. Upon hearing a senior (at least 10 years older than Ed’s mom) gleeful accounts of how he’s now back on the tennis court following a double hip replacement, someone asked “That’s wonderful; but tell me, how much did that cost, and who paid for it.” He didn’t know the precise total, though was sure it was well into six-figures, but no matter “the government paid for the whole thing.”
    Now, don’t get me wrong; I’m all for seniors (like me;-) having access to everything that modern medical science has to offer. My question is this: should tax-payers be expected to cover whatever cost it takes to put 90-year-olds back on the tennis court?
    Again, having to ask questions like this are troubling. But, as the power (and cost) of “modern medical science” inexorably expand, who and how should ask and answer them?

    • Michael Rovinsky
      Posted October 6, 2011 at 7:39 pm | Permalink

      You’re not suggesting, dare I say it, RATIONING are you? Wasn’t that idea determined to be evil in the debate over health care reform? God forbid we should ration healthcare services based on anything other than how we do it now; based on ability to pay and/or afford coverage.

      • Posted October 9, 2011 at 6:56 pm | Permalink

        I really don’t have answer. All I can say for sure is that the current and projected paradigm is unsustainable: i.e., the government cannot and will not be able to finance America’s growing healthcare appetite; and, the American people will not tolerate a system where only the wealthy have access to “miracle” treatments and tonics. As the guy in the JFK movie put it “It’s a riddle wrapped in a mystery within and enigma.”

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“Hi, I’m Ed Lovern, the executive vice president and chief administrative officer for Piedmont Healthcare in Atlanta. I created this blog to share my thoughts on the healthcare revolution and how we can all be part of the solution. Feel free to comment or email me your thoughts – I would love to have your contributions and feedback.”
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