• Monday, October 28, 2013RSS Feed

    Recovery Room Mobilization Can Make a Difference in Length of Hospital Stay

    A new study has reinforced the idea that for total hip and knee replacement patients, rehabilitation that begins in the recovery room can reduce the length of hospital stays. Researchers in the study found that 70% of rapid rehabilitation patients spent less time in the hospital than patients whose first rehabilitation session occurred the day after surgery.

    The study (.pdf), published in a recent issue of the Bulletin of the Hospital for Joint Disease, reviewed 900 hip and knee replacement patients divided into 1 group of rapid rehabilitation patients (331) and 1 group of standard rehabilitation patients (569). The 2 groups were comparable for sex, age, ASA class, anesthesia type, comorbidity groups, and time of physical therapy, although procedure length and estimated blood loss did vary somewhat between the groups, with the rapid rehabilitation group recording less of both.

    The therapy program for both groups was the same, with the only difference being when and where it began: the rapid rehabilitation patients were mobilized in the recovery room, while the standard rehabilitation patients were mobilized on the morning of postoperative day 1.The results showed that hip replacement patients averaged a 3.9-day stay in the rapid rehabilitation group and a 4.6-day stay in the standard rehabilitation group. Knee replacement patients saw a less dramatic difference, with the rapid rehabilitation group averaging a 3.6-day stay and the standard rehabilitation group recording a 4.1-day average.

    Researchers called the differences significant and cited benefits of shorter stays that included decreased patient needs for services such as blood transfusion, reduced risk of postoperative complications, and increased cost savings.

    APTA is a strong supporter of rehabilitation research, and APTA members were part of the Blue Ribbon Panel on Medical Rehabilitation Research at the National Institutes of Health (NIH). The panel's findings, which included recommendations for the development of a research plan and elevation of the National Center for Rehabilitation Research within the NIH structure, were recognized in a statement issued by APTA in January 2013.


    Comments

    I think this has proven true in a similar program we had implemented with our Joint Program. We see most surgeries on POD0 and we have received excellent feedback from the patient's. Alot of it has helped change the culture from, "we need a day to rest," towards "we better get up so we can get out!" It also really helps if the physicians are on board to begin pre-op education in clinic about anticipating d/c POD1 or POD2 coupled with joint class.
    Posted by Taylor on 10/29/2013 2:32 PM
    I am curious exactly what the therapists accomplished in the recovery room. The study states they begin with dangling and progress to 100'ambulation and 6 stairs by discharge. It did not specifically state what was accomplished that first session. We start our TKA patients and many THA patients the afternoon of surgery at the bedside. Still some of our patients who had spinal blocks cannot feel their legs. Others with general anesthesia are a still a bit groggy or nauseous. I can't imagine mobilizing this population (up on their feet and taking steps) earlier in the recovery room. It would seem unsafe.
    Posted by Allison Orofino on 11/4/2013 1:32 PM
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