Total hip replacement day case procedure wins Health Service Journal Partnership award

A total hip replacement procedure, that can now be done without the patient needing an overnight hospital stay, has won a prestigious Health Service Journal Partnership Award.

The procedure has been available at both Musgrove Park and Yeovil hospitals for almost two years, where it’s performed by each hospitals’ respective trauma and orthopaedic teams.

It means a patient is assessed, operated on, and discharged from hospital on the same day, back to their home environment to continue their rehabilitation and recovery.

And for other patients who do need a stay in hospital for clinical reasons, the average length of stay has halved from an average of four days, to just two days.

It took home first prize at the prestigious national HSJ Partnership Awards in the ‘Best Elective Care Recovery Initiative’ category, alongside Johnson & Johnson MedTech, who partnered with the hospitals to deliver this solution to optimise hospital productivity.

The Services & Solutions team at Johnson & Johnson MedTech partner with healthcare systems to deliver initiatives that transform hospital productivity and improve patient outcomes.

Debbie Vile, lead nurse practitioner for the MPH service, says she’s over the moon that the hard work done by colleagues to develop the service has been recognised in this way.

“We initially introduced a trial of this procedure as a day case, following an increase in waiting times for a hip operation during the COVID-19 pandemic, when the vast majority of planned operations were postponed,” she says.

“In 2022, our orthopaedic service at MPH treated 257 patients – an increase of over 30% on 2021, and this is only likely to increase further in the coming years, putting even more pressure on our services.

“Before our service began, half of the patients needing a total hip replacement stayed in hospital for three or more days, so it was clear that a day case service would have benefits, not only to the trust, but also our patients on the waiting list. Evidence shows that the faster a patient returns to their own home, the quicker they will recover following surgery, with a better outcome too.

“It’s working really well so far as every patient who undergoes the operation as a day case is given a range of information, advice, and encouragement on how to optimise their own health.

“They’re also taught how to mobilise safely after their operation and are given information on the painkiller medication regime they will go home on.

“Every patient has access to an on-call orthopaedic doctor via a 24 hour hotline, and they’re contacted by one of our orthopaedics colleagues on the morning after their surgery.

“This award is testament to the way our excellent team of surgeons, improvement colleagues, anaesthetists, therapies colleagues and theatre colleagues have worked together – a huge thank you to everyone.”

The average time from the patient’s first admission to their discharge from hospital was just over 10 hours, and the average time for patients entering recovery following their operation, to being safe for discharge from hospital, was just under five hours.

Following the day case project’s success, it has been expanded to all operating lists for this procedure, with the ability for patients to be discharged up to 8pm on the day.

For those unable to return home the same day, a second arrangement was developed by the team with a focus on helping patients get mobilised quicker so they can leave hospital the next day after surgery.

Mr Ben Bolland, one of our orthopaedic consultant surgeons who developed and led on the initiative, said it was fantastic news that the hard work of so many colleagues had been recognised in this way by the HSJ.

“We are really pleased to have won a HSJ Partnership Awards, which is a testament to the amazing work done by our colleagues and our partners at Johnson & Johnson MedTech, which has benefited to many patients so far,” he says.

“It has been a real change, not only for our patients, but also our colleagues, who have embraced the concept of early mobilisation and consistent patient education. For me, it has reignited a real sense of job satisfaction.

“Since we began this procedure as a day case, our patients have been brilliant in following the advice our specialist nurses have given them, to maximise the chances of them being able to go home on the same day as their operation.

“Our patients attend ‘hip and knee school’, where they are provided with all the information to understand how the operation will work, as well as what they can do to help themselves, before and after their surgery.

"Recovering outside a hospital setting is so much better for our patients, as they’re able to regain their independence much more quickly in the familiar comforts of their own home.

“We know that patients are likely to need a level of pain relief following a hip replacement, and this can be administered as normal at home without the patient needing a hospital stay.”