Short Stay Protocol


Professor W A Wallace, Consultant Orthopaedic Surgeon, Nottingham City Hospital, UK
Presented at: International Shoulder Symposium - Leysin, Switzerland - 4-5 March 2005

With the increasing emphasis on high throughput and cost-efficient use of hospital beds we have developed a system for bringing down the hospital stay for Shoulder Replacement patients to 3 days. This system depends on clearly delineating the “Patient Pathway” and then working out the most efficient way for the patient get from the start of treatment to the end.

Figure 1 – The Patient Pathway in the UK for Patients with Shoulder Pain

Each of the steps is now addressed in the pathway to ensure a smooth transition from one to the other and for the surgical route (in yellow) the steps can be made much easier if the patient is aware of exactly what will be happening to them.

We have therefore developed a Patient Guide and DVD for patients who are scheduled for Shoulder Replacement Surgery. This describes each of the surgical steps and what the patient can expect at each point on their way through the treatment plan. The guide focuses particularly on the post-operative physiotherapy, which we provide for our patients and gives them an insight into the exercises that they can expect to carry out during their rehabilitation. The DVD demonstrates these exercises actually being carried out both on patients and on models. The patients become better informed, more enthusiastic and, we believe that not only do they require a shorter stay but also they are developing a better range of motion and improved overall function after their shoulder surgery.

Figure 2 – A Patient’s Guide to Shoulder Joint Replacement


This guide is now available from Biomet Europe and can be tailored to each individual hospital’s requirements by including pages, which can be modified to accommodate local practices and different forms of post-operative physiotherapy methods.

We hope that the use of this Patient’s Guide and the DVD will change the whole ambiance of the patient’s journey along their own hospital pathway after a shoulder replacement operation.

In the UK it is now acknowledged that providing patient information is a very necessary part of the whole treatment package and funding has been specifically set aside for purchasing this sort of material where it is justified. We anticipate obtaining feedback from our patients in 2005 on how useful they have found it for their hospital stay and rehabilitation.

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