Orthopedics

      Orthopedic surgeon Kevin MacDonald, MD, with patient
Orthopedic surgeon Kevin MacDonald, MD, says the Walmart Center of Excellence program is a win-win for employers and patients.

For Hip Replacement, Center of Excellence is a “Blessing”

As an optician, Gaylene Loyd is up and down all day helping her customers. When some of them expressed concern for her obvious pain as she moved around the vision center, Gaylene knew it was time to see a doctor about her hip. An X-ray revealed the cause of her unrelenting pain: with no protective cartilage, Gaylene’s hip joint was reduced to bone rubbing on bone.

Her physician in St. George, Utah, had already mentioned hip replacement surgery when Gaylene learned that her employer, Walmart, provided total joint replacement care through a designated Center of Excellence in Seattle.

“As soon as I got the phone number for the program, an entire world of information opened up to me,” says Gaylene, who began communicating with a program coordinator at Virginia Mason. “The Virginia Mason team was in touch with me and my doctor getting all the pre-surgery information they needed. I always knew what would happen next.”

Virginia Mason’s Center of Excellence journey began in 2010, establishing best practices and directing each phase of care, from the selection and preparation of appropriate patients through surgery and recovery. The total joint replacement team conducted dozens of care improvement workshops, powered by the Virginia Mason Production System. Patient-centered innovations, including education and coaching, shared decision-making, improved pain control and other post-operative strategies, helped reduce hospital stays and recovery time, while boosting patient satisfaction.

Lyle Sorensen, MD, now-retired section head of Orthopedics and Gaylene’s treating physician, attributes the program’s success to a team that always “agrees to agree” on consistent use of best practices. Since implementation, the average hospital stay after hip replacement decreased by more than a day. Admissions to skilled nursing facilities (versus discharge to home) dropped by 60 percent. Patient satisfaction, including the improvement of pain and joint function scores, climbed to the top 10 percent nationally.

“This program has been a true win-win situation,” says Kevin MacDonald, MD, section head, Orthopedics. “Employers are assured their employees are getting appropriate surgical care, with documented excellent outcomes resulting in a quick return to work. While many of these patients travel a long distance for their care, Gaylene’s story shows how a sense of closeness and being well cared for bridges those miles seamlessly.”

Gaylene calls her Virginia Mason experience a blessing, and that includes freedom from medical bills she could never afford. Once employees qualify for total knee or hip replacement and agree to travel, there are no out-of-pocket costs. All travel and medical expenses, including an allowance for a care companion, are completely covered by the program.

“My health will determine my quality of life, and it is restored because of this,” says Gaylene. “The difference at Virginia Mason is the length the care team goes to explain every step. However small they think their individual contribution was, it meant more to me than they could imagine. I can’t tell you how grateful I am.”