Langley Memorial Hospital

1
Langley Memorial Hospital

• The Innovators

2
Building a Team

• Multidisciplinary team built over time
• Enthusiasm of team inspired co-workers
• Good team work produced good results
• THA length of stay 5.9 --gt 3.6
• TKA length of stay 4.9 --gt 3.9

3

Sustainability Strategy

• 2nd Annual Ortho Refresher Workshop
• Review, Recognize, and Recommit
• Administration support
• Staff time to attend (2 hrs)
• Catering costs
• Celebrate accomplishments
• Examined hard data
• Identified areas of improvement

4
The Ward Before Christmas

• Twas the first day post-op and all through the
  ward,
• Each patient was stirring as one accord.
• The day would proceed with a sea of new faces,
• As each of the staff assessed all their cases.
• Social work, Physio, O.T. and Doctor,
• Would all ask the nurse for the scoop on the
  floor.
• As she searched for her brains she thought to
  herself,
• Its my first day on, how is my patients
  health?
• When from 225 there arose such a clatter,
• Causing carers to exclaim, What could be the
  matter?

5

• Away to the room we all dashed to discover,
• Why the patient would take so much longer to
  recover.
• The poor soul was suffering with post-op
  confusion,
• Had torn off the O2 and now had low profusion.
• The abductor was out and the I.V. pulled tight,
• With tossing and turning and jerks through the
  night.

6

• The nurse did rush in knowing that her
  assignment,
• Was to keep hip and knee and foot in alignment.
• She replaced the pillow, checking for
  dislocation,
• Leg lengths were equal with no internal rotation.
  
• Now Physio, now O.T., now Social Work and
  Dietitian,
• On walking, on dressing, on support and
  nutrition,
• To the patient and her family, to friends large
  and small,
• Educate, educate, educate all!!!

7

• On day two post-op there was great improvement,
• So the hour had come to begin some movement.
• In came the Physio and her helper with tact,
• Plus walker, and gown and Pink Cadillac!
• The patient did walk to the station with ease,
• As thanks to the nurse she was so well analgesed.

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Next came the O.T. for lower extremity dressing,
Once practiced and ready the A.D.L. suite was
pressing. Would she pass all the tasks and be
ready for home? That was the question, as yet the
unknown.
9

• The goal for the program is amazingly day three,
• Will she make it? Is she determined?....just wait
  and see.
• Her eyes how they twinkled but she had one big
  worry,
• Would she get Q.R.P. as she lived in South
  Surrey?
• The Social Worker came and was able to say,
• For meal prep and bathing, well arrange once a
  day.

10

• The next problem to arise was this question of
  meat,
• Which she got on her tray and which she couldnt
  eat.
• She was vegetarian needing to put in her belly,
• Potatoes and pasta and a bowl full of jelly.
• The Dietitian came, and in her unique, jolly way,
• Arranged for the right food to be put on her tray.

11

• With her equipment in place, and her discharge
  pending,
• Would this patient case have a three day ending?
• The final day came and the team pulled together,
• All being directed by the Patient Care
  Co-ordinator.
• The I.V. was out and the catheter too,
• And the patient was so happy that shed done
  number two!!!

12

• The nurse had attended to the patients wound
  care,
• And the Physio had taken her up and down stairs.
• The patient was grateful and thanked everyone,
• And left us some chocolates to put in out tums.
• And as she departed and disappeared out of sight,
• She exclaimed,
• Now with no pain I can sleep through the night!

13

The Team

• Dr. Mark Mountain Anesthetist
• Dr. Albert Chan Surgeon
• Cheryl Bublitz PCC for surgical
• Leanne Sutton RN on unit
• Elaine Peters PCC for OR
• Greg McGann OT

• Marg Scherba - PAC
• Domenica Pistrin OR Booking
• Paula Kimoto Pharmacist
• Pat Patrick CNE/ Co-leader
• Trish Davidson PT/ Co-leader