21 December 2012
Whakatane Hospital Trauma and Orthopaedic Department ranked top out of 25 institutions
The Health Round Table, an independent body set up to look at quality of health care in Australasia, has recently
reported outcomes for trauma and orthopaedics.
Two of the outcomes measured were the number of days patients stay in hospital after surgery to replace hip and knee
joints, and the time from admission with orthopaedic trauma to surgery to fix the problem.
Whakatane Hospital came out top over 25 other institutions studied for the trauma time to theatre outcome. They also
came second out of 25 other institutions studied for the length of stay outcome.
“This success has not come about by chance,” said Nigel Giles, Visiting Orthopaedic Surgeon at Whakatane Hospital, “The
ethos of our department is to give patients as trouble-free a journey as possible. As with all things, excellence can
only be achieved when people pool their skills in a cooperative way.”
Whakatane Hospital’s success in these two outcomes has resulted from several specialists and professional teams
collaborating to create a carefully streamlined patient journey.
“We explain to our patients at their very first consultation that hospitals are good at treating sick people, but can be
potentially harmful to those who are well, due to the risk of hospital acquired infection,” said Mr Giles, “People
having joint replacement surgery are generally well individuals suffering pain and disability, but they are not sick.
All they need is a spare part. So the shorter their hospital stay, the lesser their chance of infection.”
Patients are invited to attend Operation Preparation Clinics where they meet with a Nurse, Social Worker,
Physiotherapist, Occupational Therapist and Anaesthetist before their operation takes place. Each of these professionals
explains their role and how they will help in the recovery process. “Patients are encouraged to ask as many questions as
possible and to make notes, as we know that clients retain less than 10% of what is said at a clinical session,” said Mr
Giles. These Clinics also provide the opportunity for the team to identify potential problems that could affect length
of stay, and plan a course of action to mitigate them.
The surgery itself has also benefited from the team of various professionals pooling their skills to streamline the
patient journey. Patients are admitted on the day of surgery, as same day admission reduces the chance of hospital
acquired infection. Clinicians have standardised procedures as far as possible to reduce error and easily identify and
treat complications. Anaesthetists combat nausea, sickness, constipation and drowsiness (all of which delay recovery) by
striving to use spinal, epidural and/or nerve blocks instead of general anaesthetic.
Finally, surgeons use the latest techniques to reduce blood loss, pain, swelling and the need for blood transfusion.
These techniques also allow them to operate efficiently and minimise time in theatre, which is known to reduce
complication rates.
“Once patients are discharged they are expected to aid their own recovery by performing the exercises learnt during
their journey,” said Mr Giles, “This helps them to recuperate faster and teaches them how to get over the pain, swelling
and stiffness.”
ENDS