Thinking Ahead for the Ideal Patient Experience: The Total Knee Replacement Project
Why not solve a problem before it happens? It’s called preventive care. Spectrum Health’s Center For Joint Replacement has already earned a reputation for knee replacement procedures with results that rank among the best in the United States. We are the only program in West Michigan that has earned Disease-Specific Care Certification for joint replacement surgery from The Joint Commission, the nation’s leading health care accrediting organization. It would be easy to leave well enough alone, but even excellence has room for improvement. A group of Grand Valley State University students, under the tutelage of Dr. John Farris, and Spectrum Health Innovations came together to pave the way to a new kind of learning experience.
The Problem: What Problem?
A good education doesn’t just teach students about what is and has been. John Farris, a professor of engineering at Grand Valley State University (GVSU) understands that. He teaches his students to think like innovators and consider what might be. When Farris heard about a grant for engineering students based on the process of discovery, he wanted to test an idea for a new kind of curriculum. With a strong relationship of collaboration between GVSU and Spectrum Health Innovations (SHI) already established, Farris approached Michael Czechowskyj RN, clinical innovation specialist at SHI, with his idea.
“Spectrum Health Innovations has already been working with GVSU for a6 couple of years,” Czechowskyj says. “We present the opportunities, educate, and guide students on the issue before us, and then we work together to solve them. But Dr. Farris thought it would be interesting to get involved earlier in the process. He chose three high-functioning, innovative graduate students for the project.” A total knee replacement procedure was the ideal process for the students to study. None of the three had extensive background in health care. Students gathered around him, Czechowskyj gave an educational presentation on the medical procedure before letting the students loose to follow the procedure step-by-step, just as the patient might experience it.
“You won’t find another model anywhere for something like this,” Czechowskyj says. “It’s a whole new way of thinking. The students come in once a week for several hours during a semester, and they meet with experts at posts along the entire procedure.”
The Challenge: Smoothing Out the Bumps
Joanne Pelton RN, BSN, ONC, NE-BC nurse manager, orthopedics, can hardly contain her enthusiasm. “We are never satisfied with mediocrity here,” she says. “I consider it part of our responsibility as nurses at Spectrum Health to create a learning environment. It’s beneficial for all of us, students as well as nurses, and it can impact nursing far into the future.” Pelton and her nurses on the orthopedic and joint replacement units allow the students to job shadow them during each step of patient care: head-to-toe patient assessment, documentation, setting up a care plan, educating the patient, administering medications, and making the patient as comfortable as possible pre- and post-surgery.
Adam Edlund, MD, FHM, medical director, perioperative medicine, Spectrum Health Medical Group, is another stop along the students’ journey. He talks with the students about what total knee replacement surgery involves. “When someone goes through knee replacement surgery, we have to take a look at the patient’s medical history, look for anything that might lead to complications,” Dr. Edlund says. “Does the patient have a history of diabetes or kidney disease? Are they ready for surgery?” During knee replacement surgery, a small layer of bone and damaged cartilage on the femur, the tibia, and the patella are replaced with artificial implants made of metal and plastic.
Impressed with the questions the students asked him, Dr. Edlund says he has enjoyed the interaction immensely and looks forward to working with Spectrum Health Innovations on similar projects in the future.
The Spectrum Health Innovations Solution: Creating the Optimum Patient Experience
While the student group following the total knee replacement opportunity identification project has not yet reached the stage of concrete ideas to pursue, everyone involved has been impressed with the exchange between medical experts and students and encouraged to try this approach on other, similar projects. “It’s a whole new way of thinking,” says Czechowskyj. “When we first looked into this approach of identifying opportunities for improvement in a medical procedure, we thought what a great learning experience for the students to have.” So far students have taken a closer look at questions such as how to manage pain better, how to lessen side effects from medications, how to make the entire patient experience more efficient. They have followed the medical procedure from diagnosis, to education on surgery, pre-procedure planning, nursing, and, finally, rehabilitation. “Later, we will filter through the ideas the students have and distill them to the three to five best,” Czechowskyj says. “If we can realize one or two of those ideas, that would be a great win.”
For more information and up-to-date happenings with Spectrum Health Innovations, follow us on Twitter @SH_Innovate.