“The tipping point is that if you go over four a day there is a much better margin and return from your dollar. There is always room for growth,” says Len Farinas, director of orthopedics and neurosurgery at 233-bed St. Mary’s Regional Medical Center in Lewiston, ME. “For us, one of our imperatives is [to] have a program that stands out in the Northeast.”
“To create a center that is efficient, you need enough volume, and not every hospital can do a joint replacement,” says Eugene S. Krauss, MD, FAAOS, FACS, a surgeon at 265-bed Glen Cove (NY) Hospital’s orthopedic and rehabilitation institute. “Every step has to be quality assured. If we make an incision and put an implant in it, that is part of literally hundreds of steps where we have to put the proper protocols to be cleared and tested with a whole team.”
To help ease transitions for patients from the time they enter the hospital through recovery and rehabilitation, some hospitals are establishing nurse navigator or joint-replacement coordinator positions that are helping to attract more people into the hospital programs. By streamlining the system through the continuum of care, hospitals and patients benefit. The idea is to enable hospitals to perform more surgeries in an environment that promotes efficiency and patient satisfaction and increases the overall patient experience.
Through much of the service line, hospitals are trying to find a competitive edge. The 305-licensed-bed Stamford (CT) Hospital has structured its leadership team to include an organizational committee that focuses on orthopedic needs and coordinates relationships between the C-suite executive committee and service line staffs. To increase its patient population related to orthopedics, including knee issues, the hospital established community meetings and conducted outreach to patients about its procedures. The hospital has no choice, says Vicki Hoffman, director of the orthopedic and pediatric service lines at Stamford Hospital. “We are situated in tight competition between two hospitals within 10 miles of us, and we are close to New York City,” says Hoffman, who is responsible for leading strategic initiatives for the hospital and works with a multidisciplinary team of clinicians and ancillary support services. “We need to stay on our game,” she says.