Practice of Medicine

Article

Orthopedic Surgeons Improve the Patient Experience

By Georgette A. Samaritan, RN, BSN, CPHRM

December 14, 2015

Today’s orthopedic surgeons face many issues, such as dealing with information technology, pushing forward biologic solutions to orthopedic problems, few insurance-reimbursed therapies, increasing costs of implants, reimbursement challenges, and increasing demands for "peer-to-peer" reviews with the insurance companies. [1]:  However, there is an ever-evolving business model that includes patient empowerment and improving the patient experience in four distinct areas of orthopedic surgical practice

  1. Proper management of postoperative expectations by improving preoperative education
  2. Patient-completed outcomes measures;
  3. Better preoperative and postoperative pain management; and
  4. Appropriately applied, minimally invasive surgical strategies.

Improving the patient experience has been shown in a number of studies to reduce the frequency and severity of professional liability claims. [2] [3] [4] [5] MMPSI consultants suggest that orthopedic surgeons consider incorporating these evidenced-based recommendations into their practices:

  • Set outcome and patient behavioral expectations immediately so that both surgeons and patients know what is expected.
  • Be clear on the realistic results of the proposed surgery. For example, it's not a back pain cure.
  • Preoperative educational classes that walk patients through each step of the surgical process have been shown to be very beneficial. Also, there are some excellent on-line procedure-specific patient educational programs that may be incorporated into a physician’s informed consent process.
  • Discharge planning is crucial. Pre-surgical discussions with patients and their families need to consider all potential obstacles associated with their post-operative living arrangements.
  • Provide compassion and empathy to patients faced with the uncertainty of their medical conditions and disability
  • Utilize a team approach. Multidisciplinary medical professionals working together throughout the entire patient treatment process often leads to a better outcome both with respect to keeping the patient engaged, and uncovering their specific issues, concerns and goals.
  • Treat pain effectively. A team approach involving nurses, physician assistants, residents and pain specialists — before and after surgery — and open communication with the patient at all points of the care continuum will help put patients at ease.
  • Postoperative pain management protocols are extremely helpful. Postoperative pain is oftentimes the patient's greatest fear. Communicating a clear plan of action regarding aggressive pain management will calm concerns and assuage fears of surgical procedures.

Finally, if a minimally invasive or less-invasive approach will achieve both surgeon and patient treatment goals, it should be pursued. Limiting surgical trauma and shortening hospital stays always improves the patient experience[6].

Published December 2015

 

References:

[1] Laura Dyrda, The biggest challenge facing orthopedic surgeons for 2015: 11 surgeons respond; Becker’s  Orthopedic Review; Monday, 03 November 2014 15:26; http://www.beckersspine.com/sports-medicine/item/22967-the-biggest-challenge-facing-orthopedic-surgeons-for-2015-10-surgeons-respond.html

 

[2] John Goodman, BS, MBA,and Dianne Ward, BS, MA ,Satisfied Patients Lower Risk and Improve the Bottom Line, Patient Safety & Quality Healthcare March / April 2008, http://psqh.com/satisfied-patients-lower-risk-and-improve-the-bottom-line

 

[3] James W. Saxton, Esq, Gregory Pawlson, MD, MHP, and Maggie M. Finkelstein, Esq, How physicians can survive the perfect storm developing in healthcare today-and thrive,  http://www.saxtonstump.com/wp-content/uploads/2015/08/How-Physicians-Can-Survive-the-Perfect-Storm-Developing-in-Healthcare-Today.pdf

 

[4] Carolyn M. Clancey, MD, Patient Safety and Medical Liability Reform: Putting the Patient First: http://archive.ahrq.gov/news/newsroom/commentaries/putting-patients-first.html

 

[5] Bhanu Prakash, Patient satisfaction, J Cutan Aesthet Surg. 2010 Sep-Dec; 3(3): 151–155.doi:10.4103/0974-2077.74491http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047732/

 

[6] IBID

 

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