Dr. Brian Johnson pictured in the new Joint Replacement Center at Baptist.

Baptist’s New Joint Replacement Center Focuses on Total Patient Experience

Before the new Joint Replacement Center at Baptist opened last October, nearly 2,000 joint replacements were performed annually on hips, knees and shoulders at Baptist Medical Center in Jackson.

With favorable patient response to the joint replacement floor that more closely resembles a boutique hotel instead of a hospital, orthopedic surgeons at the center anticipate the number of joint replacements to increase substantially.

“It’s a true destination center for patients needing joint replacement services,” said

Brian Johnson, MD, director of the Joint Replacement Center at Baptist, and an orthopedic surgeon at Mississippi Sports Medicine & Orthopaedic Center.

When preparing for the new center, Johnson and Baptist leaders looked at the entire joint replacement process from the patient’s point of view.

“Instead of going from one place to another for pre-op procedures, surgery, recovery, and post-op care, we wanted patients to be able to stay in one place for a complete loop,” said Johnson. “To ignore any one part is fraught with problems. We desired to make this a center of excellence and a place where people want to come for complete care.”

Baptist has consistently garnered clinical accolades from HealthGrades, the leading independent healthcare ratings organization, for orthopedic services. HealthGrades ranked Baptist in the top 5 percent nationwide for overall orthopedic services and joint replacement, recognized it with orthopedic and joint replacement excellence awards for 2011, and gave it 5-Stars for overall orthopedic services, spine surgery, total hip replacement and back and neck surgery. For three consecutive years, Baptist joint replacement and total knee replacement services have garnered 5-Stars.

“Rehabilitation is a vital portion of our program,” explained Johnson. “It starts in the pre-op period with a class where patients are informed about the procedure and post-op care, so they know what to expect before they enter the operation. We’ve learned that if you have certain expectations in your mind, you’re more likely to have those come to fruition because it’s your understanding of how things should be. Within that regard, patients know they’re starting rehab on the day of surgery. They know they’re going home on post-op day two. They’re prepared.”

After surgery, patients rest in a private room and bath with specialized equipment such as larger, sturdier chairs with strong arm supports to accommodate easier use.

“We don’t want patients to stay in bed,” he emphasized. “If they’re not up walking, we want them in the rehab chair resting or exercising. We want to promote a sense of wellness so that patients know they’re only going to get better. If they have the mindset that they’re sick, that’s contrary to meeting our goal.”

To facilitate the post-op transition, Baptist has initiated a program in which former joint replacement patients shepherd new patients through the rehabilitation process while they’re in the hospital. Johnson has incorporated more group therapy sessions versus individual therapy so patients have the support of fellow patients as they’re going through the process. For example, it’s not unusual for patients to wheel their rehab chairs to a conference room for group lunch to facilitate camaraderie and mutual support.

“Involving fellow and former patients has led to a very helpful and encouraging environment,” noted Johnson.

The center's new physical therapy gym features a highly specialized area with special flooring to prevent patients from slipping, and high-tech equipment to help patients accomplish daily activities such as using a walker, climbing and descending stairs, and getting in and out of an automobile and a bathtub. “When patients go home,” he said, “we know they’ll be safe and we know they aren’t fearful.”

The Joint Replacement Center at Baptist has a staff of five board-certified orthopedic surgeons trained in minimally invasive procedures, and a nurse to patient ratio of 4 to 1. Additional staff experienced in caring for joint replacement patients includes case managers, certified nurse aides, and physical and occupational therapists.

“We want joint replacement to be a good experience for patients,” said Johnson. “That means everyone has to be involved, from the nurses’ aides to therapists to dieticians to phlebotomists to the surgeons and the nursing staff. If any one of those areas falls through, or if the patient has to wait longer than expected for anything, or feels that not enough attention has been paid, then the overall experience is bad. Ninety percent can be great, but the 10 percent that falls through can sour it. Do we have it perfect right now? No, but that’s our focus. We have benchmarks in place, a dashboard of parameters we’re trying to improve, such as transfusion rates, which are going down. We also pay close attention to post-op surveys about the patient experience. If we identify something in which we’re remiss or have shortcomings, then it’s a method for us to make improvements. It’s a process in continuous evolution.”

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