Joint Replacement Surgery Amid COVID-19: How a COVID-Free Zone is Mobilizing Patients
Expert Care Amid COVID-19
At the onset of the COVID-19 pandemic, when AMITA Health St. Alexius Medical Center Hoffman Estates identified some of the very first COVID-19 patients in Illinois, the U.S. Centers for Disease Control and Prevention (CDC) established a field office in the hospital's conference room space. Working in close collaboration, CDC and AMITA Health officials developed a comprehensive, systematic program to effectively address infection risks at the hospital. As such, the medical center was one of the first in the state to establish guidelines created with the CDC including visitor restrictions, personal protective equipment, social distancing implementation, rigorous disinfection measures, staff testing, patient screening, and much more.
Establishing a COVID-free zone
Prior to their surgery, patients are tested for COVID-19 three days in advance and instructed to self-isolate. Upon arrival at the hospital, dedicated staff members screen each patient for symptoms and potential exposure to COVID-19. For joint replacement patients, a designated elevator exclusively used by the CAJR team transports them to the 2nd floor. This ensures a seamless and safe experience for patients with knee pain or a damaged joint.
Patients undergoing new joint replacement surgery stay on the dedicated 2nd floor until they are ready to go home. The floor houses the pre-surgery area, operating room, recovery area, and rehabilitation gym, all part of the CAJR unit. This exclusive access ensures a COVID-free zone and gives patients peace of mind. With strict safety protocols in place, the CAJR has successfully performed over 300 surgeries since reopening in May, prioritizing patient well-being and minimizing the risk of complications such as blood clots.
“As a physician, my first Director of AMITA’S CAJR responsibility is to do no harm. If I thought it was dangerous in any way for patients to come to our hospital, I'd stop doing surgeries,” said orthopedic surgeon Paul S. Nourbash, MD, Medical Director of AMITA’s CAJR. “But I am fully confident that things are safe, and we can give patients even more attention because of the design of our center of excellence.”
A case in joint replacement
Joan Banaszak from Itasca went through a total joint replacement surgery at CAJR in 2019, performed by Dr. Nourbash. The success of the joint replacement procedures gave her relief, knowing that her left knee would also require replacement in the future. In early 2020, the persistent joint pain became unbearable, affecting her daily activities and quality of life. Banaszak eagerly underwent her second knee replacement surgery at CAJR as soon as elective procedures were permitted again in Illinois. With the reassurance from Dr. Nourbash about safety measures, she received her new left knee in June.
AMITA Health's commitment to managing the COVID-19 situation is evident, staying up to date with global best practices. Polly Davenport, senior vice president and regional operating officer for AMITA Health's Northwest region, emphasizes the importance of keeping patients and associates healthy. The dedicated CAJR nurses, focused on caring for knee joint replacement patients, find comfort in working in a COVID-free zone. This eliminates the anxiety of contracting the virus and allows nurses to provide a more relaxed and attentive care experience.
Returning patients home sooner with computer-assisted technology
All orthopedic surgeons at CAJR are fellowship-trained in joint replacement operations, including procedure knee replacement surgery and total replacement surgery, with expertise in computer-assisted surgery. Dr. Nourbash, with over 15 years of experience, utilizes the MakoTM Robotic-Arm Assisted Surgery system for precise partial and total knee replacements.
'Computer-assisted operations can elevate good surgeons to greatness, and great surgeons to extraordinary,' stated Ms. Davenport. 'Dr. Nourbash enlightened me about the added precision during these incredibly exacting operations. This led us to embrace this technology early on and make significant investments to bring it to our communities.'
Due to significant COVID-19 outbreaks in rehabilitation centers and nursing homes, there has been a notable shift in patient preferences, with more individuals opting for shorter stays at in-patient facilities or receiving physical therapy at outpatient clinics. According to Dr. Nourbash, 'Four years ago, nearly half my patients were going to a rehabilitation facility where they lived and received their therapy. Now, less than 6% go to an extended care facility.'
Patients who want to return home just hours after their surgery can do so if they meet the criteria for same-day discharge. The vast majority of CAJR patients stay less than 36 hours at the St. Alexius Medical Center. The road to recovery starts at the CAJR rehabilitation gym where AMITA Health therapists help patients simulate common daily activities in the bathroom, kitchen, staircase, and customized therapy car with adjustable seats to prepare them for their daily lives at home.
After Banaszak had her second total knee replacement operation in June, she received seven weeks of outpatient physical therapy. By August, she reported both knees were doing well. “I so appreciate the care and kindness that Cara Dusza - my physical therapist after both knee surgeries - showed me.' Banaszak said. “Cara helped get me to where I can do things at home, get in and out of a car, go to the grocery store and to a restaurant with Bob.'
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