The Poplar Bluff Regional Medical Center, Poplar Bluff, Missouri, has changed the way its staff relates to individuals seeking joint replacements. In the first place, they do not call their clients “patients.” Individuals having elective surgery are considered students, not patients. One of the physicians who developed the innovative program, Preston Jones, M.D. says, “We do not see our patients as being sick. Instead, we see our patients as healthy individuals who are coming to the hospital because they have hip or knee pain, and want to live a better live by having joint replacement surgery.”
No Hospital Gowns. “Students” not “Patients.” Group Therapy. The Future of Surgery?
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Students do not wear hospital gowns, but rather are expected to bring their own pajamas and comfortable clothes. Students also follow a daily schedule that begins at 6:30 a.m. the morning after surgery on a unit devoted only to individuals having joint replacement surgery.
Each morning, students receive a newsletter with their breakfast, letting them know the agenda for the day. Two group therapy sessions are held daily—supplemented by individual in-room sessions. Motivational posters are located throughout the halls, and provide a guide for students to measure their success.
Students compete with one another on distance walked each day with progress tracked on a large walking board posted in a common area. Students find the camaraderie and competition to be both challenging and rewarding.
According to the Daily Journal of Poplar Bluff, each student chooses a coach—who will be an active participant in their care before, during and after discharge from the hospital. Both student and coach are required to attend a pre-operative class two weeks prior to surgery, where they meet their Bone & Joint Center team. They learn in detail about the procedure, what to expect in the hospital, and how to care for the student after discharge. Coaches learn the program right along with their students, and provide encouragement and support every step of the way.
One person—a Care Coordinator—is named to oversee the student’s entire stay, and is their resource before, during and after discharge. All of the staff at the Bone & Joint Center receive special training, and are chosen to work on the unit because of their expertise; positive upbeat nature, and high motivational skills.
“We evaluate each patient on multiple clinical, functional, and patient satisfaction criteria, ” explained Ken James, CEO. “These outcomes are then analyzed during monthly performance improvement meetings, and enable Poplar Bluff Regional Medical Center to become an efficient and cohesive team. So, when we say we offer better outcomes, we have the data to prove it.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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