Outpatient total joint replacements are growing in popularity. Driving the demand are advances in surgical technique, which have resulted in less invasive procedures that require less time to heal. To patients, the concept of recovery at-home and a shorter length-of-stay in an acute setting is extremely attractive. Together, these quality and efficiency improvements are driving down costs, which make these procedures more accessible for a broader demographic. According to one recent report, demand for knee replacements is so high that market share is expected to grow exponentially to $2.6 billion by 2026. To ensure your ASC can meet increasing demand, it is imperative to optimize and implement best practices now for total joint surgery.

Proper patient selection

When offering outpatient total joint replacements, evaluating your patient population is crucial. From general health status to non-clinical drivers of health, socioeconomic status, and screening for comorbidities, it is vital to assess a full scope of essential outpatient candidate factors.

To aid in candidate selection, facilities should adopt an in-depth pre-admission assessment screener and management process for high-risk patients. More detailed than a standard virtual patient health survey, this process will ensure that facilities can account not only for a patient’s overall health, but also how any comorbidities are being managed. In general, patients must be healthy and reasonably active to ensure a lower risk of complications and ensure they will be good candidates for outpatient procedures. For ASCs, which are dependent on consistent patient volumes and efficient procedure scheduling, the timely identification and management of high-risk patients improves your ability to reduce cancellations due to foreseeable or preventable factors.

Robust patient education

Ultimately, optimizing for surgical success and successful patient outcomes hinges on robust patient and family education efforts. Without visibility into recovery, it is essential to learn early on whether your patient will have a support system in place. Ensure your team asks questions like: Does your patient have an identified support person who will help them during recovery? Having a family member or other person who can provide supportive care during the recovery period is another factor that will affect patient outcomes.

When sharing educational materials, it is important to account for different learning styles. To start, one conversation in the pre-op setting is not enough. In addition to handouts, efficiently communicating complex medical information and instructions on topics ranging from what to bring to surgery and how to get into bed following a joint replacement, can ensure your patients and their caregivers are well prepared ahead of time.

A robust digital strategy can significantly enhance your patient education efforts. With some platforms, you can personalize and automate educational information based on the patient’s medical record. Leveraging a powerful, simple-to-use patient communication system – capable of deploying automated, individualized care instructions via a variety of mediums, including video, email, or text, and customized by clinical procedure or physician – enables centers to simultaneously standardize and personalize patient care.

Maximizing safety, efficiency, and outcomes

Another critical element of an outpatient joint replacement program is to have fully qualified staff experienced in these procedures. Your anesthesia, surgical, and recovery room teams all must be trained and experienced in the modalities that optimize patient outcomes, such as early mobilization and adequate perioperative pain control, as defined by the Hip disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS JR) and Knee injury Osteoarthritis Outcome Score, Joint Replacement (KOOS JR). Additionally, your program should include a physical therapist or another staff member who is adequately trained to determine whether it is safe to discharge a patient to home care.

Post-discharge, proper follow-up with patients is crucial for optimal outcomes. This includes a streamlined hand-off to a physical therapist, a post-operative phone call, as well as robust and strategically-timed educational material that outlines ideal activities for healing at home, promoting mobility, and stimulating recovery. As you work to put these best practices in place, not only will you maximize safety and efficiency, but patient satisfaction and outcomes will also improve.

Lastly, optimizing vendor management can make an outsized contribution to facility excellence. By improving relationships with vendor partners, facilities will eliminate points of frustration including communication gaps that contribute to canceled cases, delayed trays, and poor inventory management that drives storage issues. Over time, the output of these relationships will naturally reduce workforce burdens, improve communication across clinical teams, and boost ASCs’ abilities to manage high patient volumes and meet market demand.