A Burnley man was the first to undergo day case hip replacement surgery at East Lancashire Hospitals NHS Trust last week, an exciting new development as the Trust progresses in its aim to reduce patients’ length of stay following their operation.
Prior to his surgery, Andrew Cook, 53, served in the Armed Forces for 22 years. The intense and demanding job took its toll on his hips to the point where he needed both of them replacing. As a young, fit and motivated patient undergoing hip replacement surgery, Mr Cook was identified as an ideal candidate to trial the Trust’s first ever day case. Being fully engaged with the process, he said he was “ready and up for the challenge”.
ELHT’s Orthopaedic team have been focussing on reducing length of stay for hip and knee arthroplasty patients and the majority of patients are now staying in hospital for less than 3 days. Day case surgery for hip and knee replacements is a massive challenge and not many patients that the service lists would be appropriate for this.
Heather Robinson, an Advanced Clinical Practitioner at the Trust, met Mr Cook at his initial clinic visit. She said: “When I first met Mr Cook he was keen to explore a hip replacement as he had very little movement and severe arthritis. In fact, he had arthritis in both hips and was keen to explore having them both replaced at the same time which was not a suitable option. However, due to his optimism and motivation to recover quickly through rehabilitation, this gave me the idea that he may be an ideal candidate for our first ever day case hip replacement.”
Mr Cook arrived at Burnley General Teaching Hospital at 7.30am for his surgery last week and was met by the full multidisciplinary team who would be involved in his care.
Following the successful procedure he had to stay in bed for four hours as he waited for the numbness in his feet to disappear, but was then able to walk with the aid of a crutch along the corridor and up a couple of steps. With the physiotherapist happy with his quick progress, he was able to leave by 6.30pm the same day and continue his recovery at home.
Speaking a couple of days following the surgery, Mr Cook said: “It was all a bit of a whirlwind really so I haven’t had much time to reflect as it was all so quick. I had a massive clock in front of me in my recovery room so it was a bit like clock-watching, I was just eager to get moving and get going!”
He continued: “It’s really benefitted me recovering at home rather than the usual 3 days in hospital. My family have been around me which has put less worry on them and it also means there’s been less pressure on the staff to look after me so they can get on with looking after other patients who need it more than me. I’m in control of my own physio and medication which is really great and I’ve been for a couple of walks – so far, so good!”
Mr Choudry, Clinical Director of Trauma and Orthopaedics at the Trust and the operating surgeon, was delighted to be able to take this case and lead on this new process which will benefit both patients and staff.
He said: “We were able to support Mr Cook because we have an excellent multidisciplinary team who support patients undergoing hip and knee replacement surgery. The whole team were excited and enthusiastic about the challenge.
“I am proud of the service the Orthopaedic team have delivered from attendance at the outpatients clinic, through to hip and knee school and pre-operative assessment to prepare him for surgery. There is also the ward and therapies team, enhanced recovery team, dedicated theatres and the anaesthetic team to ensure he had a safe surgery and effective post-surgery rehabilitation.”
With the first case now a success, the outcomes and learning can be shared with the lower limb team in the hope of offering day case surgery to more patients who fit the criteria.
Heather Robinson added: “Evidence shows that a patient recovers better at home in their own environment. This reduces the risk of infections, reduces the length of stay for the Trust and most of all for the patient who is not in hospital for a prolonged period. We’re really pleased this was such a success and are excited to reflect on how this could be taken forward to maybe include other patients who are felt to be appropriate for this new pathway.”