Hip and knee replacements are by far the most common orthopedic surgeries in the United States. In 2018, the Centers for Medicare and Medicaid Services (CMS) removed knee replacements from its list of hospital inpatient-only procedures, which paved the way for these procedures to be performed in an ambulatory surgery center (ASC). In January 2020, CMS also removed hip replacements from this list. In December 2020, CMS announced plans to migrate over 300 musculoskeletal Common Procedure Codes (CPT Codes) from the inpatient-only list to the ASC list. Today, performing outpatient joint replacement surgery without a hospital stay is a growing trend. Qualified patients can undergo hip, knee, and shoulder replacement surgery early in the morning, begin walking an hour after surgery, and be home for dinner.
Gregory Tocks, DO, Medical Direction of the NPSC - Lebanon Outpatient Joint Replacement Program, stated “We are proud to be the first ambulatory surgery center in Dauphin, Lancaster, and Lebanon counties to offer patients the option to have joint replacement surgery in a state-of-the-art outpatient setting.” These procedures may seem overwhelming to some patients; therefore, each patient is assigned a dedicated Nurse Navigator, who works one-on-one with the patient and their health coach to guide them through the entire joint replacement journey. NPSC-Lebanon utilizes clinical pathways through CareSense that were developed collaboratively with nursing staff, physician assistants, clinical support staff, physical therapists, and fellowship trained joint replacement surgeons. These clinical pathways allow all members of the care team to communicate, educate, and check-in with their patients. This decreases anxiety, sets realistic expectations and leads to successful outcomes.
Dr. Ike Obioma, Medical Director and Director of Anesthesia for NPSC- Lebanon, uses a multi-modal approach that helps to minimize pain and nausea for the patient. This is accomplished by using alternatives to narcotics in conjunction with an at home pain management plan developed during the pre-op period. Patients recover quicker, have less pain, and experience fewer complications.
NPSC-Lebanon provides patients with the opportunity to have their hip and knee replacements in an outpatient setting which is safe, efficient, and provides high quality personalized care at a lower cost. Upon checking in with a Nurse Navigator, a patient commented on his joint replacement journey.
“I just wanted to say a HUGE thank you to you, Dr. Tocks, Jen, the WHOLE surgical staff, and the office staff of OAL. THANKS!! Micaiah and Gwen were very nice… Grace got me lunch from the cafe. She really enjoyed her breakfast and lunch there. Again, thanks for the gift card for her. Thanks again for being there today.”
Patients who need joint replacement surgery want to get back to their normal lives, Executive Administrator, Melissa A. Weik, MHA, RN, stated “NPSC-Lebanon gives patients the option to achieve their goal without a costly hospital stay.”
