Totally Golden

MCMC’s Total Joint Program again receives the rare distinction of earning the Gold Seal of Approval accreditation for quality of care.

Dr. James Reardon is used to practicing big-city medicine. Before joining MCMC Sports Medicine and orthopedic Surgery last summer, the joint replacement specialist practiced for 22 years in Kansas City and chaired for six years the Orthopedic Division of a large Kansas City hospital.

He knows what big-city medicine looks like. He just didn’t expect it to look like Mid-Columbia Medical Center.

“I think people tend to look at small community hospitals and not always be terribly impressed by them, but they should be when they look at MCMC,” Dr. Reardon says.

Dr. Reardon is speaking both generally about the entire MCMC organization and specifically about the Total Hip and Knee Replacement programs he now directs. The latter two programs were recently re-accredited with the Gold Seal of Approval by The Joint Commission, which signifies they meet or exceed that independent, not-for-profit organization’s stringent patient care and safety standards for hip and knee replacement surgery and rehabilitation.

Accreditation is a rare achievement that fewer than a dozen total joint programs in Oregon hospitals share. MCMC’s program, which includes orthopedic surgeons and the hospital’s surgery, nursing and rehabilitation teams, is the only one in the region to earn this distinction.

“My hospital in Kansas City did 1,200 joint replacements a year and they did not have accreditation,” Dr. Reardon says. “It really is unbelievable that MCMC has once again earned this distinction. It’s very special.”

Hip or knee replacement surgeries are performed more than a million times each year in the U.S. Most people who undergo the procedure suffer from osteoarthritis. The most common form of arthritis, this condition affects nearly 14 percent of adults over 25 years old and more than one-third of people over 65, according to the Centers for Disease Control and Prevention.

At MCMC, the majority of total joint patients are between 60 and 80, but procedures have been performed on patients as young as 40 and as old as 90. They enter the Total Joint program with painful, stiff joints, often with very simple goals — for example, hoping to one day take their grandchildren to the park or play with them on the floor.

“I just saw a patient the other day whose goal was to walk through the grocery store without pain,” says Anna Saltonstall, lead physical therapist at MCMC. “The Total Joint team defines success in terms of how successful our patients are in achieving those functional goals,”

The total joint replacement process begins when a patient is referred for surgery by his or her healthcare provider. After a preoperative medical assessment, all patients attend Joint Camp, a morning-long presentation covering all aspects of surgery and recovery. During Joint Camp, members of the MCMC team, which includes nurses, pharmacists and physical therapists, give patients information and advice about what lies ahead.

Surgery normally requires a three-day hospital stay. During that time, patients receive intensive occupational and physical therapy. Patients are released from the hospital with a discharge plan that outlines the patients’ and caregivers’ next steps, whether that is going home or to a care facility for more rehabilitation.

After discharge, members of the MCMC Visiting health team and therapists make home visits for up to two weeks. Then the patient continues therapy in the outpatient setting of Water’s Edge.

The recovery process generally takes six months. At MCMC, the Total Joint team strives to meet a series of goals designed to continually improve patient care, as well as meet the accreditation requirements of The Joint Commission.

Although the accreditation process is time consuming, Total Joint staff is committed to the process to ensure the best possible outcomes for patients, says program coordinator Kim Hartley, R.N.

“It ensures we use the most up-to-date medical practices and constantly make the program better for our patients,” Hartley says. “And it gives our patients the confidence of knowing they are receiving care that meets the highest standards for quality.”

There is no overstating the quality-of-life improvement that a successful joint replacement surgery can bring, says Dr. Reardon, who estimates he has performed “thousands” of the procedures in his long career. He relates the story of a surgical colleague in Kansas City with osteoarthritis in his knee that had become so bad he could barely move after a day performing surgeries.

After recovering from knee replacement surgery performed by Dr. Reardon, the surgeon not only was practicing surgery pain free again, he was also back to running 20 miles every week, biking 40 miles and finishing triathlons in record times.

“He is a very happy man,” Dr. Reardon says. “There’s no value you can put on a grateful patient, a happy patient who now has their life back.”

But it’s not difficult to measure the value of patients in pain being able to receive the benefits of big-city joint replacement care without leaving the comforts of their own small community.