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Further example of a successful enhanced recovery pathway for hip and knee replacement patients

2010 March 3
by webmaster

The benefit of implementing enhanced recovery pathways for hip and knee replacement patients is well established in the literature. However, there is a gap between this knowledge and the experience of many patients within the United Kingdom. The content of an enhanced recovery pathway is not controversial for hip and knee replacement patients, and the elements which make up the pathway are all accepted as “best practice”. However, there are still relatively few units which have been able to successfuly implement enhanced recovery pathways.

The reasons for the failure of widespread adoption are many, and a variety of explanations are often given by units on why they cannot implement changes or why their hospital is different. One way of helping to persuade units that implementing an enhanced recovery pathway is possible is to look at case studies of success from other units. As you can see from this list on the Department of Health website, the settings are varied and the units are spread across the United Kingdom.

One hospital which has been successful at implementing an orthopaedic enhanced recovery pathway is the Golden Jubilee National Hospital in Glasgow and last week I had the opportunity to visit David MacDonald who is the pathway co-ordinator at the Golden Jubilee. I left Glasgow hugely impressed by the work of David and his team and it was great to see another unit achieving excellent results by implementing the principles of enhanced recovery for hip and knee replacement patients.

At the Golden Jubilee Hospital they have developed a regime for patients which includes a comprehensive programme of pre-operative education, multimodal analgesia and multi-disciplinary accelerated education which they call the CALEDonian Technique (Clinical Attitudes Leading to Early Discharge). Click on the link below to see the presentation David recently gave at a Department of Health Event in Newcastle.

Caledonian Enhanced Recovery Presentation – David McDonald

The results of the pathway are impressive and show a reduction of length of stay, reduced infection rates and complications, and improved oxford scores in comparison to the traditional technique used at the hospital. These results are soon to be published in the literature and we will signpost the paper on this blog as soon as it is available.

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