New York City’s Hospital for Special Surgery Transfers Knowledge to Pioneering Surgical Center in London

New York, NY—March 16, 2004

Manhattan’s Hospital for Special Surgery (HSS), a world leader in orthopedic surgery and research, will be recognized on March 19 by Queen Elizabeth and the British government for its landmark role guiding the development of an innovative new orthopedic center in London that has adopted HSS’s best practices in patient care and treatment protocols for hip and knee replacements.

The new center, the Southwest London Elective Orthopedic Center (SWLEOC), which opens after a three-year knowledge transfer consulting program with HSS, is part of a British National Health Service (NHS) initiative to incorporate best practices and improve health care in the U.K.

Her Majesty Queen Elizabeth and His Royal Highness The Duke of Edinburgh will officially open the new center on March 19. HSS Chief Executive Officer John R. Reynolds will attend the ceremonies.

The knowledge transfer was initiated after a study conducted by the Royal College of Surgeons and the British Orthopaedic Association in 2000 on outcomes for hip replacement surgery in the U.K. found patients experienced long waiting times followed by lengthy hospital stays for hip and knee replacements Furthermore, a quarter of the patients left the hospital with severe walking restrictions. The NHS designated HSS as a resource partner for knowledge transfer with four NHS trusts in Southwest London – Mayday, Kingston, St George's and Epsom / St Helier. HSS began working with the trusts in 2000 to replicate the HSS patient-focused system of care at every level by transferring its quality models of infection control, patient education and patient "throughput" and rehabilitation protocols.

After instituting HSS’s best practices, SWLEOC began conducting elective hip and knee replacements in January 2004, performed by surgeons from each of these four NHS trusts. The center has seen a significant reduction in costs, improved outcomes and increased patient satisfaction. Length of stay rates have decreased by more than 50% with the average length of stay dropping from an average of more than 12 days to 5.8 days. In England, cutting the length of stay to six days will translate into an estimated savings of £1,500 per patient according to the Health Service Journal. As a result, the waiting times for hip surgery are expected to decrease to an average of six months compared to the current wait of 12 to 18 months.

"The patient-focused system of care we developed here at HSS will allow the new South West London Elective Orthopaedic Centre to perform over 3,000 joint replacement surgeries per year, which is double the number previously performed at all four trusts," said John R. Reynolds, CEO of the Hospital for Special Surgery. "The entire HSS team has been honored to work at SWLEOC with so many highly qualified and dedicated professionals. Their commitment to ensuring that they provide their patients with the highest quality care has made this alliance a very meaningful and rewarding one for all involved."

"We collaborated step by step with our SWLEOC colleagues as they developed the center," Reynolds added. "Throughout the knowledge transfer process, HSS experts engaged in peer-to-peer discussions and training sessions with their London counterparts. The process ranged from sharing our rehabilitation protocols and patient education curriculum, to ensuring the SWLEOC environment was designed to improve patient flow, patient rooms and surgical throughput."

Giles Mahoney, chief executive of the Southwest London Elective Orthopaedic Centre, said, "The partnership with the Hospital for Special Surgery has enabled SWLEOC to establish a modern and effective service for hip and knee replacement patients here in Southwest London. By applying HSS's quality standards to our education and training, audit and research operations, SWLEOC will provide an unprecedented environment in which surgeons can perform hip and knee replacements and significantly reduce the long waiting lists in our region."

Over a three-year period, the HSS team assisted SWLEOC by:

• reviewing architectural designs to create environments and traffic flow that reduced risk of infection;
• improving rehabilitation protocols;
• improving infection control protocols;
• enhancing nursing care protocols;
• creating a patient education centered clinical pathway;
• educating staff on continuous quality improvement management, methods and implementation.

Initially, SWLEOC will perform only hip and knee replacement surgery, serving the four Southwest NHS trust hospitals. The center has four operating theatres, a post-anesthetic care unit comprising 15 beds, as well as 50 inpatient beds. In the past, surgical patients in the U.K. were generally admitted one to two days before their procedure, tying up beds and adding to the extremely long waits for operations. At SWLEOC, patients are being admitted on the day of their surgery. They also are participating in pre-operative education, which focuses on empowering them to be active in their recovery. Post-operative rehabilitation will be initiated earlier in the patient’s recovery than is standard in the U.K.