Shorter hospital stays for orthopaedic patients

Patients are spending less time in hospital following orthopaedic surgery thanks to a move to seven-day working in therapy services at Grimsby hospital.

The recruitment of new staff, including a physiotherapist and a therapy assistant, has enabled the team, which provides both physiotherapy and occupational therapy, to cover weekends.

Orthopaedic patients need to be reviewed by therapy staff and declared fit for discharge before they can go home. The move to seven-day working has already seen a reduction in the length of stay (LoS) for patients.

Between April and December 2018 the average LoS for both planned hip and knee replacements was 5.2 days – it’s now 3.8 for knees and four for hips. It means patients can expect to go home as early as the day after their planned surgery. It’s also benefiting patients who have had fractures who may have had to stay in hospital over a weekend waiting to see therapy staff on Monday.

Lead physiotherapist Tim Fletcher said: “Our aim has always been to get patients up and moving around as soon as possible after surgery. Patients generally want to get home quickly. We also know the longer individuals stay immobile in bed, especially elderly people, the more likely they are to succumb to problems like pressure sores, chest infections and other complications.
“Getting them moving quickly after surgery also helps with their confidence. The move to seven-day working is already helping us reduce the amount of time people are staying in hospital after their surgery, which can only be a good thing for their recovery.”

The team are aiming to achieve a maximum three day LoS for all planned hip and knee replacements within the year by working with the wider multidisciplinary team, which is looking at ways to ensure patients have no other delays to their discharge.

Adrian Jones, 48, recently underwent his second hip replacement and was back home the next day.

He said: “When they told me I could be going home the next day it did feel a bit quick at first, but I’m young for this kind of operation and was steady on my feet.

“With my first hip on the day of the operation they stood me up and then I got back in bed. With this one I had a little walk on day one and then the next morning they had me walking up and down the stairs which meant I was able to go home.”

Mr Jones, who has had the same surgeon for both hip replacements, says the recovery is going even better than he expected: “When I had my first hip done the leg was really bruised, my thigh was black for about a month, but with this one I’ve not had any bruising at all and it’s been less painful. As the weeks go on I think it’s definitely been a quicker recovery; it’s not as stiff and I have more movement.”

Having had two hip replacements at Grimsby hospital he is full of praise for the staff. He said: “They were absolutely amazing, from the reception ladies to the girls who make tea, they are all just brilliant. There’s no two ways about it though, everyone would rather be at home than in hospital, even though everyone’s lovely there.”

Scunthorpe and Goole hospitals already offer some level of seven day physiotherapy services.