the bone and joint center annual report · annual report tony digioia, md, ... the bone and joint...

THE BONE AND JOINT CENTERANNUAL REPORTTony DiGioia, MD, Medical DirectorGigi Conti Crowley, Program Director

The Bone and Joint Center at Magee-Womens Hospital of UPMC is committed to providing a pathway to wellness while delivering exceptional care experiences for patients and families that need the evaluation and treatment of hip, knee, spine pain and arthritis.

The Hip and Knee Arthritis Care Home and the Team for ALL of Your Care

•••Your Home Away From Home!

Welcome to the Magee-Womens Hospital Bone and Joint Center

Mission Statement

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2011 was one of the most transformative years we have had at Magee. We prioritized, simplified and took action to drive The Orthopaedic Program’s continued success. We changed our name to The Bone and Joint Center at Magee-Womens Hospital to become a more comprehensive center with the goal of continuing to increase our ability to deliver exceptional care experiences to our patients and families.

In this current market we are fortunate to be a center built on a number of tremendous strengths. Our patient satisfaction scores remain high, our clinical outcomes are among the best reported. Our patients are vocal and share with enthusiasm why they choose The Bone and Joint Center: our expert physicians, our dedicated staff, our innovation and collaboration with Patient and Family Centered Care initiatives and our ability to deliver exceptional care experiences and our commitment to their success.

As we acknowledge our many accomplishments on the following pages, we are also proud of the dedication and commitment of our staff. We are grateful to many organizations for our close collaborations: Walk It Forward – Operation Walk Pittsburgh, The Innovation Center, AMD3 Foundation and Renaissance Orthopaedics, as we continue to aspire to the highest standard of care.

While we acknowledge the changing dynamics in today’s healthcare marketplace we remain confident in our ability to deliver exceptional care experiences and look forward to the year ahead for The Bone and Joint Center.

Anthony M. DiGioia, III, MD Gigi Conti CrowleyMedical Director Program Director

Anton Plakseychuk, MD Brian Hamlin. MDAssociate Director Associate Director

A Message from the Directors

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Anthony M. DiGioia, MD - Medical DirectorGigi Conti Crowley - Program DirectorBrian R. Hamlin, MD - Associate DirectorAnton Y. Plakseychuk, MD - Associate DirectorPeter A. Siska, MD - SurgeonDarlene Marx - Data Specialist and Assistant to Gigi CrowleyTraci McGowan - Sr. Admin. Assistant and Assistant to Tony DiGioia

Pre-Operative TestingKathleen Barton, CRNP - Certified Registered Nurse PractitionerFrances Richardson - Patient Care TechnicianMichelle Williams - Administrative Assistant

Operating Room TeamLoren Morrison, RN BSN - Patient Care Manager OR CoordinatorRichard Brown - Surgical Tech IITerry Hardin, RN - Professional Staff RNNoreen Harrison, RN - Professional Staff RNMichael Simko - Surgical Tech IIDarcie Skrzycki - Surgical Tech IIDiane Wilson, RN - Professional Staff RNMark Wockley, RN BSN - Professional Staff RNLucretia Wright - Surgical Tech II

Day of Surgery/Pre-testing Nursing StaffJanice Harmon, RN - Professional Staff RNThomas Maidens, RN BSN - Professional Staff RNLeslie Pope, RN BSN - Professional Staff RN

Physician AssistantsMichael Halahan, PA-C - Surgical PADaniel Hoffmann, PA-C - Surgical PAKristy Tully, PA-C - Surgical PAMichael Zigler, PA-C - Surgical PA

Community Medicine Inc.Beth Catone - Office CoordinatorDebra Eperthener - Surgical SchedulerMeghan Hathaway - Patient Information Coord.Gregory Lee - Medical Assistant

OutcomesTimothy Levison, MS - Quality Management Coordinator

Care Team Members

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In 2011, the Orthopaedic Program at Magee-Womens Hospital became the Bone and Joint Center. With the change came new promotional materials.

The Orthopaedic Program becomes the Bone and Joint Center

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Since his

gotten a real lift. hip replacement, Bob has

Bob StoehrHip replaced in JulyOn the slopes by December

The Orthopaedic Program is now

the Bone and Joint Center.

To learn what Magee’s Bone and Joint Center can do to treat your arthritis, hip, knee or back pain,

call 412-641-8150 or visit UPMC.com/MageeBoneandJointCenter.

Affiliated with the University of Pittsburgh School of Medicine, UPMC is ranked among the nation’s best hospitals by U.S. News & World Report.

THE BONE AND JOINT CENTER AT

2171_upmc_bone_joint_poster_bob_b_snipe_Layout 1 5/4/12 11:11 AM Page 1

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The Orthopaedic Program becomes the Bone and Joint Center





Ladonna left

in the dust. her knee pain

Ladonna BatesKnee replacement

patient



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Ladonna left her knee pain in the dust.

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We have added new members to our Operating Room (OR) Team this year. Staff rose to the challenge of adding another surgeon to our Team. These hardworking, dedicated groups of people have the BEST turnover times in the country and their efficiencies in the OR cannot be matched by others!

Operating Room Team

Bottom row from left to right: Janice Harmon, RN - Pre-op Nurse; Loren Morrison, RN - OR Coordinator; Terry Hardin, RN – OR Nurse; Lucretia Wright, - Surgical Technologist; Tom Maidens, RN – Pre-op Nurse;Top row left to right: Mike Halahan, PA-C – Physician Assistant; Mark Wockley, RN – OR Nurse; Diane Wilson, RN – OR Nurse; Rick Brown - Surgical Technologist; Laura Brown, RN – OR Nurse; Stephanie Rose, Surgical Technologist; Darcie Skrzycki - Surgical Technologist; Dan Hoffmann, PA-C – Physician AssistantMissing from picture: Kristy Tully, PA-C – Physician Assistant; Mike Zigler, PA-C – Physician Assistant

Not finance. Not strategy. Not technology. It is teamwork that remains the ultimate competitive advantage, both because it is so powerful and because it is so rare.

-Thomas Lencioni, Author of “The Five Dysfunctions of a Team”

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...our unique clinical program remains at the forefront of implementing Patient and Family Centered Care.

The pre-operative testing center continues to provide a one-stop visit, solely dedicated to meeting the expectations of our patients and their families. We continue to perform all of the testing needed for surgery, along with group and individualized education for patients, their “coaches” and family members.

The Center consists of a specialized TEAM that focuses on patients’ and families’ needs. Our goals are to create a stress free hospital experience and obtain 100% patient and family satisfaction. We strive for ensuring a speedy and healthy recovery and to maximize improvement in our patients’ outcome. The Bone and Joint Center offers a complete continuum of patient and family focused care, spanning diagnosis and teaching, surgery, inpatient hospital recovery and the rehabilitation process. This comprehensive model of care focuses on the needs of our patients and families, covering all phases of their care and focuses hospital resources on our patients’ and families’ needs.

A visit to the pre-testing center gives each patient having surgery at Magee the opportunity to incorporate all testing and education into one visit. Appointments are made in tandem with the surgical date for patient convenience.

A Patient’s Journey to Wellness Begins with...

Under the Direction of Dr. Anthony M. DiGioia, III, MD, Medical Director of The Bone and Joint Center, the 4100 Orthopaedic Unit has been practicing Patient and family Centered Care since the unit opened in February 2006.

We are also happy to have a beautiful state-of-the-art Orthopaedic Unit. This unit was designed to provide a comfortable, relaxed setting for patients and families to enjoy. The unit includes large private rooms and a patient and family lounge. Other amenities include Internet access via WiFi, full café style room service, valet parking and a massage therapist for our patients. Our Center includes a state-of-the-art gym and workout area right on the unit.

The Bone and Joint Center strives to obtain the best medical care available and our team of nurses, therapists, and the staff is 100% committed to our patients’ care and needs.

The reports on the following pages show how the satisfaction scores of our outstanding staff on 4100 exceed the needs and expectations of our patient and their families. Most importantly the likelihood of recommending the hospital to others and overall rating of care, our goal is to score above the 80th percentile as compared to our peers. We continue to score in the 99th percentile nationally!

Your Home Away from Home

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Exceptional care, from an exceptional hip and knee joint replacement team.







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Our exercise program at Magee-Women’s Hospital has had another successful year working with the Bone and Joint Center.

• 92% of our total hip replacement patients and 89% of our total knee replacement patients were discharged home with an average length of stay between 2-3 days in the hospital.

• As for our total hip replacement patients 54% were discharged home using a walker, 44% using a cane, and 2% independent without an assistive device.

• 89% of patients receiving a total hip replacement were able to complete out of bed functional activity on the day of their surgery. All of our patients also experienced an increase in functional mobility as well after surgery.

The Patient’s Playbook Consists of: • Initial evaluation at bedside on the day of surgery. • Patient education on plan of care, precautions on goals.• Progression to stationary bike, treadmill and Wii for balance activities.• Perform your daily workout in the comfort of your own clothes!• Having a “coach” with you every step of the way.• Stair training, car transfers, preparation for discharge to home!

We want to provide you a consistent and dedicated staff for our patients. We try to have the same therapist with each patient to develop a relationship and maintain consistency throughout their stay. In order to help ensure the best treatment for our patients we have developed a competency and test for all of our physical therapists to pass. We are working towards ensuring that our patients receive the best possible care after their surgery to give them the jumpstart to their journey to wellness.

Our Exercise Program and Your “Personal Trainers”

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In an effort to continually improve patient and family care experiences within the Bone and Joint Center, the following pages contain our quality outcomes. By reporting these measures we insure that we are striving to deliver exceptional care experiences for our patients and their families while also delivering the best outcomes, quality, and safety and doing all efficiently so we can reduce medical cost. Measuring and reporting these outcomes reflects our center’s commitment to transparency and accountability.

How We Measure Up...Clinical Outcomes, Quality, Safety and Patient Experience

The Patient Experience: What our Patients are Saying

• You’re the best! Thanks to all of you for the expert care I was shown.• I am deeply grateful for the medical services provided. Thank you!!• Everyone was caring, thoughtful and kind excellent care.• Very grateful for the wonderful care!• The best hospital stay I have ever had. Thank you very much!!• I had a very good experience. I feel very fortunate, thanks to all of you! • Thank you for the wonderful care I received! • Everything was very well organized. Just a great experience.• It was an amazing experience. The doctors and staff, along with family and friends were all praying for me. What an amazing combination.• This was probably as ideal a procedure and care as it could possibly be. Glad I made this choice!• Pain management was excellent. I was never in severe pain. Thank you.• Excellent treatment and very positive experience. I have already sent 3 patients to your program.• Everything about this procedure was great. I’m so glad I had this done and certainly have and will continue to recommend The Bone and Joint Center and Magee-Womens Hospital to everyone.• All your staff was super. Be proud of your entire team!

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The Patient Care Experience

“As a patient looking for an orthopaedic surgeon I was interested in what friends and family members had to say about the choices available to me. They all raved about the care they received in The Bone and Joint Center and I knew it was the right place for me.”

We have been able to build a base of very loyal patients and even evangelists by continuing to deliver exceptional care experiences and clinical outcomes.

We ask patients about their experiences and satisfaction based on the care provided by our Care Givers. The willingness to refer friends and family members to The Bone and Joint Center remains above 99.5%, while the overall rating of care received remains above 95% over the past 5 years!

“Would you recommend The Bone and Joint Center at Magee-Womens Hospital to family and friends?”

“How would you rate the overall care you received while you were a patient at Magee-Womens Hospital?”

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Procedure volume (number of cases per hospital or surgeon) has become one of the widely used quality indicator for post-surgical outcomes. Studies have demonstrated that patients receiving total knee and hip replacements in higher volume hospitals (defined as an annual volume exceeding 200 primary and revision replacement procedures) generally have lower rates of mortality, infection and other selected complications than do patients in lower volume hospitals. Studies have also shown that there is a positive relationship between outcomes and the number of total knee and total hip replacement procedures performed at a hospital.

In 2011, The Bone and Joint Center at Magee-Womens Hospital of UPMC performed 1,276 total knee and total hip replacement (primary and revision) procedures, which included 696 primary knee replacements, 417 primary hip replacements and 163 knee and hip revision procedures.

Total Number of Patients Undergoing Surgery at The Bone and Joint Center 696 - Total Knee Arthroplasty (TKA) 417 - Total Hip Arthroplasty (THA) 83 - Revision Total Knee Arthroplasty 80 - Revision Total Hip Arthroplasty 192 - Other various procedures 1,468 - Total Surgeries for Patients

696 Primary Total Knee Replacement Patients Average Age: 66.2 (Range = 22-88) Gender: 64% Female, 36% Male Average Length of Stay: 2.9 days (Range = 1-11) Discharge Destination: 89% Patients sent directly home

417 Primary Total Hip Replacement Patients Average Age: 61.5 (Range = 17-89) Gender: 53% Female, 47% Male Average Length of Stay: 2.7 days (Range = 1-12) Discharge Destination: 92% Patients sent directly home

Developing High Performance Teams

“While searching for an orthopaedic surgeon I was interested in finding a practice that performed a large number of surgeries each year. I knew the more surgeries done the better the outcome would most likely be.”

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Although the majority of patients who undergo total hip and knee replacement surgery are between the age of 50 and 80, the distribution graph shows that patients come from varied age groups. In 2011, the average age of primary hip replacement patients was 61.5 years with a range of 17 to 89 years old, while the average age of primary knee replacement patients was 66.2 years with a range of 22-88 years old.

Patient Demographics

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“I was hesitant at first to go ahead with scheduling my surgery as I felt I might be too young to have a joint replacement. I came to find that I was within just a few years of the average patient age. This made me much less anxious and made my decision to go forward with the surgery easier.”

Table 1. Patient Age Groups with Number of Procedures Performed Patient Age Total Hip Replacements Total Knee Replacements

15-19 3 0 20-24 5 1 25-29 2 0 30-34 7 2 35-39 2 6 40-44 16 4 45-49 27 10 50-54 40 38 55-59 65 102 60-64 77 157 65-69 60 130 70-74 49 127 75-79 37 78 80-84 23 41 85-89 6 17

Patients followed the national trending of hip and knee replacement patients when comparing gender distribution across the procedures. Women comprised 53% of primary total hip patients and 64% of primary total knee patients, while males made up 47% of primary total hip patients and 36% of primary total knee patients.

Female MaleTotal Hip Replacement Patients 222 195Total Knee Replacement Patients 448 248

Patient Demographics

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The average length of stay (measured in days) provides general information about the efficiency of care delivery, as well as Care Giver performance, and is therefore an important quality indicator. According to the most recent national statistics from the Agency for Healthcare Research and Quality (AHRQ) (2009 national data most recent available), the National average length of stay for knee replacement is 3.4 days and for hip replacement 4.3 days.

In 2011, patients were able to go home much more quickly with an average length of stay for primary total knee patients of 2.9 days and for primary total hip patients 2.7 days. While at the same time, 89% of knee patients and 92% of hip patients were able to go directly home following surgery. Going directly home following sur-gery is important, as it has been shown to be associated with lower post-operative complications while also allowing for greater independence in walking, climbing stairs, and getting into and out of bed and chairs.

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“Going into surgery I had a lot of uncertainty about how long I would have to stay in the hospital and where I would go once I left. I was relieved to find out that I would only spend a few days and that most likely I would be sent directly home to recover with my families help.”

Average Length of Hospital Stay and Discharge to Home

Surgical site infections affect approximately 500,000 patients per year according to a recent Centers for Disease Control and Prevention report. Numerous factors such as age and general health status of persons undergoing surgery can affect rates of infection. Surgical site infections contribute to surgical morbidity and mortality regardless of procedure. Infection following total knee replacement and total hip replacement is a relatively uncommon but serious complication.

In 2011, Infection rates for The Bone and Joint Center were 0.3% for primary total knee replacements and 0.9% for primary total hip replacements, compared to the national infection rate average of 1.5% for total knee replacements and 1.3% for total hip replacements.

Infection Rates

“Developing an infection after my surgery was a big concern for both me and my family so finding an orthopaedic surgeon with a good history of low infection rates and assertive preventative measures was very important to us.”

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Healthcare providers can improve surgical care and reduce the risk of infection after surgery by providing the right medicines, at the right time, on the day of surgery. The Surgical Care Improvement Project (SCIP) is a national quality improvement project designed to improve surgical care and reduce surgical infections in hospitals by encouraging careful selection and timely use of antibiotics for surgical procedures. The timely administration of antibiotics prior to surgery has been shown to reduce surgical site infections.

Using the Surgical Care Improvement Project (SCIP) measures, there is a concentrated effort to raise the bar on provider quality through the use of pay-for-performance programs to differentiate payment among providers based upon their performance. Thus, it is important that providers achieve the highest levels of performance possible and deliver cost-effective, high-quality health care.

The SCIP Measures for Infection Prevention Include:• Appropriate prophylactic antibiotic selection for all surgical patients• Prophylactic antibiotic received within 1 hour prior to surgical incision• Prophylactic antibiotic discontinued within 24 hours after surgery end time

In 2011in the Bone and Joint Center, 100% of patients received appropriate antibiotics while 100% also received prophylactic antibiotics within one hour prior to surgical incision and 96% had their antibiotics discontinued within 24 hours after surgery. All measures were significantly above the national and state averages.

Surgical Care Improvement Project

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The mortality rate (measured as a percentage) provides another piece of general information about the quality of care delivery. Total knee and total hip replacements have a relatively low mortality rate. The known predictors of in-patient mortality include age and the presence of any significant coexisting conditions.

According to the most recent data available (2009) from the Healthcare Cost and Utilization Project’s (HCUP) Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality (AHRQ), the inpatient mortality rate for knee replacement is 0.2% and 1.2% for total hip replacement.

In 2011, The Bone and Joint Center’s inpatient mortality rate was 0% for primary total knee replacement and 0.2% for primary total hip replacement.

Mortality Rate

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Tracking the number of patients who experience unplanned readmissions to a hospital after a previous hospital stay is another category of data used to judge the quality and outcomes of hospital care. It is important to note that not all readmissions are related to the previous surgery, and some readmissions are not preventable.

The Bone and Joint Center has initiated several improvement efforts that focus on the transition of care from the hospital to home and incorporate effective and organized discharge planning. Care Giver-Patient and Family communication at the time of discharge encourages the active involvement of patients and their families in the patient’s own care and provides critical follow-up care instructions to help prevent complications following surgery. Well organized discharge plans that are communicated clearly with the patient and family help reduce the rate of readmissions by providing patients the care instructions needed to facilitate the care transition for patients returning home.

Readmission Rates

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“My family and I were concerned about the recovery period and the thought of having to take care of myself at home following surgery. These fears were short lived as the discharge instructions we received communicated clearly what to expect and how to care for myself during my transition home. I also received a follow-up phone call at home a few days later making sure everything was going well and that I had no problems or concerns.”

The Bone and Joint Center at Magee-Womens Hospital of UPMC follows a very well organized blood conservation protocol that limits the number of blood transfusions required of our patients. Receiving blood transfusions could potentially lead to an increased hospital length of stay, increased risk of infection and an increase in overall health care costs. With this in mind, we do everything we can to minimize blood loss during and after surgery, although a blood transfusion is sometimes required following joint replacement. The Bone and Joint Center continues to have the lowest transfusion rate following joint replacement surgery of any orthopaedic unit within UPMC and has one of the lowest in the nation.

In 2011, the average rate of transfusion for primary total hip replacement was 4% and for primary total knee replacement patients it was 8%, giving The Bone and Joint Center an overall transfusion rate of 6% for primary total joint replacements. 2011 Blood Transfusions – Primary TJR Total number of Surgical Patients 1113 Number of Patients Transfused 72 % of Patients Transfused 6%

Our Blood Conservation Programs

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The success of a patient’s outcome following total knee and hip replacement surgery is partly due to the rehabilitation following surgery. The ultimate goal is ensuring the patients’ function as soon as possible in order to improve quality of life. Exercising the hip and knee muscles following surgery is extremely important to the success of the joint replacement. Using a rapid recovery program, rehabilitation begins immediately after surgery as patients work with a physical therapist on the day of surgery. Achieving a functional range-of-motion is an important element to a rapid recovery and return to full mobility. We continuously collect and analyze therapy data to ensure we are providing optimal rehabilitation results that allow patients to recover as quickly and effectively as possible.

Primary Total Hip Replacement Patients (N=323) Distance Patient Able to Walk Post-op day 1 98 ft (range 0-500) at Discharge 129 ft (range 0-600) Pain Score Reported Pain on post-op day 1 5.7 (range 0-10)(Based on a scale from 0-10, with 0 Pain at discharge 3.9 (range 0-10)being no pain and 10 being severe pain.)

Day of Surgery Activity Walked 82% Stood at bedside 5% Sat on edge of bed 8% No activity 5% Support Patient Used at Walker 68%Discharge to Home Cane 29% None 3%

Our “Gym”, Physical Therapy and Functional Outcomes

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“The therapy I had following my surgery was difficult but I knew how important it would be to get my leg moving again as soon as possible. The exercises were challenging but fun as each therapy session put me one step closer to achieving my goals and returning to an active lifestyle.”

Primary Total Knee Replacement Patients (N= 644) Knee Range of Motion Extension post-op day 1 -9° (range 0 to -30°) Extension at discharge -6° (range 0 to -18°) Flexion post-op day 1 80.1° (range 25-127°) Flexion at discharge 91.6° (range 36-132°) Distance Patient Post-op day 1 72 ft (range 0-300ft)Able to Walk at Discharge 121 ft (range 0-600ft) Pain Score Reported Pain on post-op day 1 7.3 (range 0-10)(Based on a scale from Pain at discharge 4.9 (range 0-10)0-10, with 0 being no pain and 10 being severe pain.) Day of Surgery Walked 62%Activity Stood at bedside 10% Sat on edge of bed 18% No activity 10% Support Patient Walker 84%Used at Discharge Cane 15%to Home Crutches 1%

Our “Gym”, Physical Therapy and Functional Outcomes

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HCAHPS stands for Hospital Consumer Assessment of Healthcare Providers and Systems. In the summer of 2002, the Centers for Medicare and Medicaid Services (CMS) asked the Agency for Healthcare Research and Quality (AHRQ) to develop an instrument to measure patient perception of care. This measurement is used to publicly report hospital performance (care experiences as perceived by patients). The goal of this public reporting instrument is to provide consumers with information that might be helpful in choosing a hospital. CMS has also stated that it should complement rather than compete with quality improvement instruments already being used by hospitals.

Measuring Patient and Families’ Care Experiences

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“A few weeks following my surgery I received a patient satisfaction survey in the mail. It asked questions pertaining to my overall hospital experience as well as how staff treated me, pain management, room cleanliness and whether I would refer the hospital to friends and family. I appreciated the opportunity to share my thoughts about my hospital stay.”

Bone and Joint Center State Avg. National Avg. National Percentile Rank

Overall Rating (% 9 and 10) 83 62 64 98

Would Recommend (% Def. Yes) 86 65 68 96

Comm with Nurses (% Always) 82 74 74 88

Comm with Doctor (% Always) 90 78 80 99

Responsiveness of Staff (% Always) 71 61 62 91

Cleanliness of Room/Bathroom (% Always) 75 68 69 75

Quietness at Night (% Always) 60 49 56 74

Pain Management (% Always) 76 67 68 89

Medicine Comm (% Always) 67 57 59 86

Discharge Information (% Yes) 97 80 80 99

The Bone and Joint Center national percentile ranking over 5-year period based upon reported HCAHPS scores.


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Press Ganey Patient Satisfaction Survey

The Press Ganey survey data allows for comparison of satisfaction scores to peer groups, e.g., hospitals with the same bed volume, and to benchmark their scores. Press Ganey Associates, Inc., is the recognized leader in satisfaction measurement for the health care industry and is the world’s largest health care satisfaction measurement firm, processing more than four million surveys annually for over 1,200 current health care client organizations. This data provides tested, reliable satisfaction surveys, comprehensive management reports, and national comparative databases for our nation’s performance improvement initiatives.


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2011 Press-Ganey Scores: The Bone and Joint Center

1/1/11 - 12/31/11

2011 Score National Percentile Ranking

Overall Assesment of Hospital Stay 91.6 99th

Likelihood of Recommending Hospital 94.8 98th

Overall Rating of Care Given 94.7 99th

Admission Assessment 95.1 99th

Room Assessment 86.7 92nd

Meals 89.9 99th

Nursing Assessment 92.6 97th

Tests and Treatments Performed 92.0 99th

Visitors and Family Comfort 91.7 97th

Physician Assessment 92.6 99th

Discharge Process 91.1 99th

In an effort to understand how we are doing, and make real-time transformations, patients and families are asked to tell us about their care experiences by completing the following survey questions 1 month post-operatively.

The Bone and Joint Center Patient Care Experience Survey

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1. How would your rate the parking services you experienced Excellent Very Good Average Fair while a patient at Magee-Womens Hospital?

2. How would you rate the pre-op testing that you had in the Excellent Very Good Average Fair Orthopaedic Program?

3. How was your experience the day you came in for surgery? Excellent Very Good Average Fair

4. How would you rate the nursing care on Unit 4100? Excellent Very Good Average Fair

5. How would you rate the food and the cafe style food service? Excellent Very Good Average Fair

6. How would you rate the therapy that you had while you were Excellent Very Good Average Fair a patient on Unit 4100?

7. How would you rate your orthopaedic surgeon? Excellent Very Good Average Fair

8. How do you feel that your post-op pain was managed? Excellent Very Good Average Fair

9. Did you experience any nausea after your surgery? Please rate 0 1 2 3 4 5 on a scale of 1-5. 0 = none; 5 = severe

10. How would you rate your discharge process from the hospital? Excellent Very Good Average Fair

11. How would you rate your therapy at home after your surgery? Excellent Very Good Average Fair

12. What agency did your home therapist work for? ___________________________

13. How would you rate the overall clenliness and maintenance of Excellent Very Good Average Fair the hospital?

14. How would you rate the overall care you received while you were Excellent Very Good Average Fair a patient at Magee-Womens Hospital?

15. How would you rate the kindness shown by the health professionals Excellent Very Good Average Fair involved in your care?

16. How would you rate the health professional’s ability to answer Excellent Very Good Average Fair questions in a sensitive and caring manner?

17. How would you rate the degree to which the health professionals Excellent Very Good Average Fair involved in your care went beyond the call of duty in caring for you?

18. How would you rate the degree to which the health professionals Excellent Very Good Average Fair treated you as a mature, responsible individual?

19. How would you rate the degree to which you were treated with Excellent Very Good Average Fair respect and dignity?

20. Would you recommend the Orthopaedic Program and Magee- Excellent Very Good Average Fair Womens Hospital to family and friends?

21. Do you have any suggestions how we could have made the _____________________________ Orthopaedic Program experience even better _____________________________ for you and your family? _____________________________

The Bone and Joint Center Patient Care Experience Survey Results

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From 1/1/2011 to 12/31/2011

Total Responses: 718

Excellent Good Average Fair Poor

Parking: 43% 43% 12% 1% 1%

Pre-Op Testing: 70% 28% 1% 1% 0%

Day of Surgery: 72% 25% 2% 0% 1% Care on Unit: 66% 28% 5% 1% 0%

Dietary: 45% 40% 12% 3% 0%

PT on 4100: 61% 34% 3% 1% 1%

Surgeon: 92% 7% 1% 0% 0%

Post-Op Pain Mgt: 50% 37% 6% 4% 3%

Discharge Process: 59% 32% 8% 1% 0%

Care at Hospital: 66% 30% 3% 1% 1%

Cleanliness: 55% 40% 4% 1% 1%

Kindness: 74% 22% 2% 1% 1%

Sensitivity: 66% 30% 3% 1% 0%

Call of Duty: 57% 34% 7% 1% 1%

Maturity: 66% 29% 3% 1% 1%

Respect: 71% 26% 3% 0% 0%

Home PT: 61% 35% 0% 3% 1%

YES NO

Nausea After Surgery: 37% 63%

Would You Refer to 99.7% 0.3%Orthopaedics at MWH?

In Our Patients’ Words...

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“When friends ask me how I am doing since my total knee replacements, I proudly tell them about the 14-hour flight for my long-delayed dream trip to China where I climbed the Great Wall, or about my new bicycle and the joy of riding again, or how I am able to walk the long platforms at train stations up and down the East coast.”

-LaDonna - TJR patient

“Without this surgery, the pain and immobility would have forever ended my adventures under or above the water! When I had been told that I needed a new hip, my fear and apprehension were greater than that of facing large sharks! But, the professionalism, knowledge, and expertise of the good doctor and his staff gave me the confidence to undergo this surgery. My life is now back to where I want it to be, and my husband and I still travel, dive, bike, and garden as a contact sport!”

-JoAnne - TJR patient

“There was a lot of encouragement given to Kristen on her ‘road to recovery’. One particular instance happened on one of her last times to Physical Therapy before going home. As she was leaving PT on her way back to her room, there were so many nurses, aides, and even some patients standing and cheering her on as she walked by. This is one of those times that will forever be embedded in our memories.”

-Family Member - TJR patient

Each year we celebrate the successes of our patients with our Annual Patient and Family Reunion. This past year was no exception as we celebrated a Walk it Forward event at the South Side Works walking trail. Our patients were up and moving and we all took a walk to celebrate and help support our partnership with Operation Walk-Granting The Wish To Walk.

Patients and families enjoyed an afternoon of healthy snacks, walking, exercise and fun! The event raised $3,000 for Operation Walk Pittsburgh, a program started by Dr. Tony DiGioia in 2008 that provides free hip and knee surgeries to patients without access to such care.

Annual Patient and Family Reunion

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Walk it Forward

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“I was and still am grateful for all that was done for me and that is why I decided to become involved...The fact that I have been given the opportunity to be a volunteer counselor and to help educate potential knee replacement patients with my knowledge of experience has been extremely important to me. Once, I was that potential knee replacement patient so I can honestly say I know what they are going through mentally and physically.”

-Vicky - TJR patient and Walk it Forward Volunteer

We invite all patients to participate in our Walk it Forward program. This volunteer initiative offers a variety of ways for our patients and their familiy members to get involved and help us grant the wish to walk.

Ways to Walk it Forward:

The Patient and Family Advisory Council – This group of former joint replacement patients and their families shares their individual stories and brainstorms creative ways to help others going through joint replacement surgery.

Voice of Experience Volunteers – Voice of Experience volunteers provide off-site support to patients by answering questions via telephone or email or by attending a Bone and Joint Health Series event as a patient panelist.

Patient Navigators – Patient Navigators are former patients willing to support new patients post-operation and offer encouragement during a patient’s journey to wellness.

Operation Walk Pittsburgh Volunteers – These volunteers help with fundraising efforts for the Operation Walk Pittsburgh initiative. Operation Walk Pittsburgh is a volunteer effort that provides free hip and knee replacement surgeries to people in developing countries and locally who do not have access to such care.

Walk it Forward is a Magee-Womens Hospital Bone and Joint Center Program. To learn more about the Bone and Joint Center visit www.BoneAndJointHealth.org. Call 412-641-1924 or email [email protected] for additional information.

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Your Journey to Wellness

As part of our continued commitment to promote Patient and Family Centered Care, our program is excited to announce a new feature item devoted to our patients!

Since the patient stories in our PFAC newsletters have been such a huge success, we are going to begin to highlight a patient’s story in a new monthly article called “Your Journey to Wellness-A Patient’s Story”. This article will be composed by the patient and will be published on a monthly basis.

“After suffering more than three years of bone-on-bone arthritic pain in my hip, I finally opted for surgery with a total hip replacement by the incredibly skillful team headed by Dr. Anthony DiGioia in December. Four days following the surgery, I was driving my truck (very carefully), resuming light chores around the house, and NOT utilizing the pain medication that was prescribed for me (In fact, I suffered less pain following the surgery than I did prior to it). Within four months, I was in Mississippi, escorting 53 students and adult chaperones, building houses with Habitat for Humanity. It was a week of rigorous physical labor, accompanied by long walks through airports, New Orleans, and on the beach. Again -- no pain. During this past June, I completed my 14th MS150 Escape to the Lake ride, where I pedaled 150 miles over two days, from Pittsburgh to Conneaut, Ohio, for victims of multiple sclerosis. Ironically, I completed this ride faster than any previous ride. Pain scale: Minimal.

I owe my present excellent health and mobility to the Orthopaedic Program at Magee-Womens Hospital, and to Dr. Anthony DiGioia, III, in particular.”

-Richard Yount - TJR Patient

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A JOURNEY TO WELLNESS March/April 2011

For the past 25 years I spent most of my winter weekends skiing at Seven Springs Mountain Resort. For the past 10 years I based the majority of my skiing activity on downhill racing. Every year I spend many hours a day trying to improve my technique and times.

About two years ago I noticed some pain in my left hip. The pain progressed pretty fast and my racing activities suffered. At first I told myself it must be my lower back and I proceeded to go to a chiropractor. The chiropractor after looking at some x-‐rays, told me it was not my back, but I would need a hip replacement in the near future. I continued to tell myself I could put off the hip replacement and I continued my normal activities but with much pain. I went through another ski season but had to rely on over the counter anti-‐inflammatory medicine to make it through the day. In December of 2009, I visited Dr. DiGioia finally admitting I needed to have the surgery. I was told I would need to wait 3 months to get on the surgical schedule. At this point I should have scheduled but I wanted to get another complete ski season in, so I waited until April to call and set the surgical date. The date was set for July 6, 2010 at 7:00 am. The day of the surgery came and I can remember talking with the anesthesiologist outside the operating room about skiing of all things. The anesthesiologist told me they were going to give me something to make me a little sleepy. The next thing I remember was waking in the recovery room with the nurse asking me to wiggle my toes. That night the physician’s assistant came to my room about 6:00 pm and had me stand with the aid of the walker. Besides my leg feeling heavy and stiff, my pain level the first day was virtually non-‐existent. On day two, I walked to the first physical therapy session using a walker still with very little pain. The afternoon PT session ended with me walking back to my room using a cane. After the first day of PT, I noticed an improvement everyday and met other patients that were having similar recovery experiences. After leaving the hospital, I spent 1 week at home with home physical therapy. I started driving that Sunday and drove myself to church. The following week I planned on staying

A PATIENT’S STORY BY ROBERT STOEHR

home from work and start outpatient therapy, but I ended up going into work for two meetings. At that point I returned to work the next week, full time, while going to outpatient therapy for nine sessions. Fast-‐forward to December 11, 2010 (5 months after surgery) my first time out on the slopes. I decided I would take it easy the first day just to get a feel of skiing with my new hip. The first two runs down the beginner slopes convinced me my hip was working a lot better than it had the prior ski season. My third run I intended to ski down another beginner trail, but next to the slope I spent most of my time racing on. Well, my ski buddy, Bill Lever, who by the way is 77 years old and skis with a knee replacement, convinced me to ski down the slope where most of my race activities took place. I skied down the slope and could not believe how my skiing instincts were taking over and any fear of my hip replacement was fading. By the time I took the chairlift back up, racing

January 30, 2011 Robert Stoehr is back on the slopes

again

Bob with one of his ski

buddies, Bill Lever

IF YOU WOULD LIKE TO SUBMIT A STORY AND SHARE YOUR “JOURNEY TO WELLNESS,” PLEASE CONTACT THE ORTHOPAEDIC PROGRAM.

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A JOURNEY TO WELLNESS PAGE 2

gates were appearing on the slope. On this slope, every weekend, races are held and racers compete against the clock to obtain various medals. The program is called NASTAR (National Standardized Race) and each racer is compared against a pacesetter and then nationally ranked. This slope is where I spent most of my winter weekends for the past 10 years. So, for the forth run on my new hip, I decided to ski 5 or 6 gates to get the feel of the new hip. No problem, everything seems to work as before, but with no pain! It is now February 13, 2011 and every week I have increased my skiing activity. So far this year I have raced in over 50 NASTAR races and my times are getting better. I am happy to have my skiing activity back with no pain. I am, however, aware that I need to take it a little easy, but it is hard when no pain exists and I must balance my ability to ski with caution as it has only been a little over 7 months since my surgery. As I mentioned earlier, I was reluctant to admit I needed to have a hip replacement at age 52, but it seems so little time lapsed from the surgery to going back to work to skiing that it was just a minor event in 2010. I would like to thank Dr. DiGioia and his staff for making the hip replacement go so smoothly that I can hardly believe I fit it in between ski seasons.

~Robert Stoehr

(CONTINUED)

Renaissance Orthopaedics 300 Halket Street, Suite 1601A Pittsburgh, PA 15213 Phone: (412) 683-7272 Fax: (412) 683-0341 www.orthodoctor.com

The Orthopaedic Program 300 Halket Street, Suite 1601B Pittsburgh, PA 15213 Phone: (412) 641-8643 (for appointments) Fax: (412) 641-8657

Bob is feeling great after his total hip replacement and is back to racing

Surveying the NASTAR Course

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The Bone and Joint Center provides free educational lectures to various communities in the region via the Community Outreach Program (CO). The mission of the CO Program is to educate the affected population about arthritis and the treatment options that are available, including joint replacement surgery. Our goal is also to promote awareness about the state of the art “Patient and Family Centered Care” that is available through the Orthopaedic Program at Magee-Womens Hospital of UPMC, not only to the more widely affected female population, but to the male population as well.

Although the educational program is currently being extended into various UPMC senior communities, we have collaborated on establishing an effective educational series for the residents of the Devonshire of Mt. Lebanon and the Country Meadows of South Hills, where Dr. Brian Hamlin was on site to talk about the latest advances in hip and knee reconstructive surgery and to answer questions to a group of interested individuals.

Community Outreach

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SO YOU THINK YOU NEED JOINT REPLACEMENT SURGERY?

Begin Your Journey to Wellness Right Here!

Saturday, April 30, 2011

Magee-Womens Hospital of UPMCAuditorium, Zero LevelAdmission is free, but advance registration is required.

To register, call 412-641-1924 or visit www.boneandjointhealth.org.

Anthony M. DiGioia, MDChairman

Speakers:Becky Carter, DPT

Brian Hamlin, MD

Anton Plakseychuk, MD, PhD

Program Schedule9:15 to 9:55 a.m.Check-in and light refreshments.

Learn about the latest from companies that fo-cus on hips and knees.

10 a.m. to 12:00 p.m.

• What is Hip and Knee Arthritis and When is it Time to Consider Surgery?

• Your Steps to Wellness Before, During and After Joint Replacement Surgery

Exercise Before and After Joint Replace ment

What’s New and on the Horizon for Hip and Knee Arthritis

Truth & Consequences: Panel Discussion (Program is subject to change.)

Jointly sponsored byThe AMD3 FoundationRenaissance OrthopaedicsMagee-Womens Hospital of UPMC

•

•

•

BONE & JOINT HEALTH SERIES

FREE ADMISSION!

Sign Up Now!

Call 412-641-1924 or register online at www.boneandjointhealth.org

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BONE AND JOINT HEALTH SERIES

Call 412-641-1924 or visit www.BoneandJointHealth.org

FREE ADMISSIONLet Your Journey to Wellness Begin!Hip, Knee Arthritis and Joint Replacement Surgery

Saturday, October 15, 2011Magee-Womens Hospital of UPMC300 Halket Street Pittsburgh, PA 15213Auditorium, Zero Level

Admission is free, but advance registration is required.

Jointly sponsored byThe AMD3 Foundation Renaissance Orthopaedics andThe Bone & Joint Center at Magee-Womens Hospital of UPMC

Anthony M. DiGioia, MD Chairman

Speakers:Annie Hahn, MPTPeter Siska, MDAnton Plakseychuk, MD, PhD

Program Schedule

9:15 a.m. to 9:55 a.m.Check-in and light refreshments.

Learn the latest from companies that focus on hips and knees.

10:00 a.m. to 12:00 p.m.• What is Hip and Knee Arthritis and

When is it Time to Consider Surgery?

• Your Steps to Wellness Before, During and After Joint Replacement Surgery

• Exercise Before and After Joint Replace- ment

• What’s New and on the Horizon for Hip and Knee Arthritis

• Truth & Consequences: Panel Discussion

REGISTER TODAY!

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About the AMD3 Foundation

The Orthopaedic Program at Magee ranked as one of the best by U.S. News and World Report

The mission of the AMD3 Foundation is to pro-mote education, research and other related charitable activities in patient and family cen-tered care. The Foundation was o cially estab-lished in 2003 as a non-pro t organization.

Spearheading these e orts is Anthony M. DiGioia III, MD. In addition to being the founder of the organization, he is also a practicing orthopaedic surgeon from Renaissance Orthopaedics at Magee-Womens Hospital of UPMC, and Clinical Associate Professor of Orthopaedic Surgery at the University of Pittsburgh School of Medicine. Dr. DiGioia has organized and chaired several conference and series on Patient and Family Cen-tered Care; Bone and Joint Health; and Less and Minimally Invasive and Computer Assisted Orthopaedic Surgery. Dr. DiGioia is also Senior Research Scientist at Carnegie Mellon University.

We are very pleased to announce that Magee Orthopaedics ranked 42nd in the TOP 100 according to the 2011 U.S. News and World Report. This achievement is especially impressive since The Orthopae-

dic Program at Magee was started only 5 years ago.

U.S. News and World Report created The Best Hospitals Rankings Pro-gram more than 20 years ago to identify hospitals exceptionally skilled in handling the most di cult cases. Being named among these high-performing hospitals is evidence of our commitment to putting patients rst and providing exceptional care experiences.

Magee-Womens Hospital of UPMC was also ranked nationally in Gyne-cology and Cancer, in addition to Orthopaedics. UPMC Hospitals were ranked in several clinical specialty areas throughout the UPMC Health

System. UPMC hospitals were also ranked in 15 of 16 adult Specialty Areas.

This unique achievement is an honor and a testament to the dedication and commitment of our team and everyone at Magee who touches our patients’ and families’ experiences and continues to deliver exceptional care experiences every day.

Operation Walk Pittsburghwww.operationwalkpgh.org

Operation Walk is a private, not-for-pro t, volun-teer medical services organization which provides free joint replacement surgeries for patients in developing countries and Pittsburgh that have no access to life-improving care for arthritis or other debilitating bone and joint conditions. Operation Walk also educates in-country orthopeadic sur-geons, nurses, physical therapists and other healthcare professionals on the most advanced treatments and surgical techniques for diseases of the hip and knee joints. This is done in conjunc-tion with surgeries to help create a lasting contri-bution to patient care in developing countries.

For more information or to make a donation to Operation Walk, please contact Carey Knapp at 412-641-5486 or [email protected]

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The Bone and Joint Center is proud to be affiliated with Operation Walk Pittsburgh.

Operation Walk is a private, non-profit organization that provides free hip and knee replacement surgeries for patients in developing countries and in the US who have no access to life-improving care for their arthritis. The program was founded in 1994 by Los Angeles orthopaedic surgeon by Dr. Lawrence Dorr. Operation Walk has visited over 12 different countries and has operated on thousands of patients.

Operation Walk Pittsburgh was started by Dr. Tony DiGioia in 2008 and has since completed over 150 surgeries for patients in Central America and right here in Pittsburgh. These efforts are supported by a volunteer team of some of Pittsburgh’s finest medical professionals as well as volunteers.

In 2011, Operation Walk Pittsburgh traveled to Panama City, Panama and completed 55 total joint replacement surgeries (7 hips, 48 knees) on a total of 45 patients. The group also completed 3 surgeries in Pittsburgh.

Operation Walk Pittsburgh

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1 2 3

4 5 6

1. OR Nurses Rita Weatherholt, Sue Caldwell, Margaret Senge, Liz Zeolla, Diane Wilson, Gail Florence and Qin Jin 2. CRNA Ngocha Dang, Dr. Plakseychuk, Dr. DiGioia and PA Mike Halahan performing a total knee replacement 3. PT Marc

Marchese and his grateful patient 4. Dr. DiGioia giving a rosary to his patient. A patient in Pittsburgh made the rosaries for him to give to the female Panamanian patients 5. Operation Walk Pittsburgh group photo 6. Dr. DiGioia, PA Mike Halahan,

Angela DiGioia and patient 7. Dr. Hozack, Dr. Muzzonigro, Dr. Plakseychuk, the First Lady of Panama, Dr. Weiss, Dr. Uskova and Dr. DiGioia 8. Local Panamanian dancers 9. Three patients who came in as strangers and left as friends

To learn more about Operation Walk Pittsburgh, visit www.operationwalkpgh.org

7 8 9

Snapshots of PANAMA 2011

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Operation Walk Pittsburgh Vital Stats

Antigua, Guatemala August 2009

50 Patients 63 Joint Replacement Surgeries 13 Bilateral Joint Replacements

Youngest Patient Age: 21Oldest Patient Age: 82

Antigua, Guatemala August 2010



Panama City, Panama September 2011


Youngest Patient Age: 40 Oldest Patient Age: 81

Pittsburgh, PANovember 2010 & 2011

6 Patients 6 Joint Replacement Surgeries

5 Knee Replacements, 1 Hip Replacement


www.OperationWalkPgh.org

MAGEE-WOMENS HOSPITAL OF UPMC300 Halket Street, Suite 1601B Pittsburgh, PA 15213

MWH406497 08/12 © 2012 UPMC

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

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