Last week the team at Salisbury Hospital achieved the first full hip replacement in a day.
Vanessa De Rycker aged 67 from Salisbury was admitted at 08:00 on the morning of 28th April and was home that evening by 19:00. This is the first time such a procedure had been completed within a day in the Wessex Region and one of very few in the country.
The achievement was down to a team effort starting with pre-operative assessment and Occupational Therapy, then anaesthetics, the theatre team, therapists, pharmacy and the ward staff. Everyone played their part.
The surgery was led by Mr Ivor Vanhegan who said: “The team have been working towards this for some time. Over the past few years, we have had great success with day case partial knee replacements and ligament reconstruction, however, this is the first total joint replacement of a hip or knee that has been operated on and discharged on the same day. The development work has enabled us to reduce our average length of stay for this type of procedure by a whole day up to the point where we have achieved this goal. It’s fabulous.
The process started before the patient came through the theatre doors. We carefully assessed the patient to make sure she was suitable and that she had all the right equipment and support at home. When she arrived the whole team was well prepared to avoid delays and knew that as long as the procedure went according to plan the lady would be home that very same day. The effort by the whole team was phenomenal.
The beauty of being able to deliver this type of surgery in a day is that the patient has a better experience as they are able to recuperate in the comfort of their own home. It also reduces pressure on our hospital staff by reducing the number of people staying overnight.
The benefit of achieving this goal will be felt by all orthopaedic patients as the full team has learnt so much and is now embedding these ways of working.
Hopefully, through an assessment process, we will identify more suitable hip or full knee replacement patients and can move towards this becoming part of normal practice.”
Mrs De Rycker describes her experience: “I was very pleased that I could be discharged back home on the same day after my total hip replacement and avoid having to stay in hospital overnight.
This was the result of the excellent care and efficiency of everybody in the multidisciplinary team from the surgeon and the anaesthetist to the theatre nursing staff, post-operative recovery care, pharmacists and physiotherapists. The operation was carried out under epidural and sedation, so I was pain-free and in a pleasant cosy snooze and only minimally aware of the process of surgery.
The surgeon proposed same-day discharge in Recovery whilst my legs were still numb and immobile, so I was sceptical at first. However, I regained enough movement for me to complete the Physiotherapy assessment and walk with crutches including up and down practice stairs. I had been provided pre-operatively with the equipment to support me at home by the Occupational Therapy team. I received good nursing care from the Student Nurse on the Ward including the management of the pain relief regime.
By early evening my husband came to collect me, and we travelled home in the car where I settled down for a celebratory non-alcoholic beer. I have been pain-free and try to ensure that I keep moving during the day as much as possible. It has made such a difference being able to go home and I am sure that my recovery will benefit from that.”
Dr Peter Collins, Chief Medical Officer, said: “This is a great achievement and done at a time when the hospital is incredibly busy. Successes like this will help hospital services achieve full recovery post-COVID, reduce waiting times for treatment and ease pressure across the hospital. It’s great news.”