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Western Sussex Hospitals NHS Trust

Orthopaedics recovery programme slashes hospital stays

Changes to the recovery process for patients undergoing hip and knee replacement surgery at Western Sussex Hospitals NHS Trust are producing “better than hoped for” results, according to nurses.

Teams at the trust developed the “Chichester and Worthing Enhanced Recovery Programme” for planned hip and knee replacements. The programme was first used in July and is now fully operational.

In the past patients receiving routine hip and knee surgery normally spent about seven days in hospital. Since the programme was introduced, the average stay for hip and knee patients has fallen to four days.

The proportion of patients needing a blood transfusion after surgery has also plunged from 12% to just 1%, and the proportion of people needing a urinary catheter fitted after surgery has fallen from 40% to 7%.

The “enhanced recovery” approach introduces several key changes:

  • Joint School – a two-hour session involving anaesthetists, physiotherapists, occupational therapists, dieticians, and specialist nurses.
  • Anaesthetics – most patients no longer receive a general anaesthetic, but instead have a spinal injection, along with sedation.
  • Rehabilitation – because patients are feeling so much better after surgery, they can begin to move far more quickly.
  • Telephone follow-up – patients are contacted by a member of the team two days after leaving.

Cassie Moore, the nurse lead for the project, said: “The early results are better than we could have hoped for.”

“It is great to see patients being able to recover so quickly, and to feel so much better than they used to - we are thrilled at the way this improvement has had such an obvious and positive impact for our patients.”

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