Best Care in Action: UTMB's Rehabilitation Services revamp "joint boot camp"

Getting a knee or hip replaced is a major surgery requiring weeks—sometimes months—of recovery. As you can imagine, most patients have numerous questions and concerns for their health care team leading up to the operation.

A newly revamped “boot camp” class led by UTMB’s Rehabilitation Services department aims to educate and ease preoperative nerves so patients and their caregivers know exactly what to expect before, during and after a total joint replacement.

“We fill in all the holes of the process from 30 days out to hospital discharge and beyond—it’s like an itinerary,” said Karen Chapman, DPT, director of Rehabilitation Services. “The patient truly becomes a member of the team and understands their role and responsibilities, along with all of ours, to make sure they have a really good outcome.”

The free hour-and-a-half class is held at each of UTMB’s three campuses at various times of the month and is specifically for individuals who have already seen their orthopedic surgeon and have scheduled a total hip or knee replacement surgery. A nurse and physical or occupational therapist lead the class, which covers everything, from packing for your hospital stay to managing pain and recovering at home. Patients are encouraged to bring a family member or caregiver with them.

The classes originally began about eight years ago as a collaboration between the Rehabilitation Services department in the Health System and Orthopaedic Surgery and Rehabilitation in the School of Medicine. The program underwent a transformation last October to add more structure to the class and ensure all patients receive the same information.

“One of the main goals behind boot camp is to have a consistent message across the board,” said Chapman. “Whether a patient is having surgery at Jennie Sealy, League City Campus or Angleton Danbury, everyone is hearing the same things. So it was truly a collaborative effort because we had to meet with pre-op nurses, anesthesia nurses, surgeons, and inpatient and outpatient therapists to make sure all our efforts were aligned.”

In addition to providing consistent information and boosting patient satisfaction, the classes aim to improve health outcomes by reducing infection rates and hospital length of stay.

“We start out each boot camp by having patients fill out a risk assessment prediction tool, which basically helps us preplan for a patient’s discharge by predicting whether an individual may need inpatient rehab or can be discharged home right after surgery,” said Chapman. “We also talk about the risks and signs of infection—and how to minimize the risk by things such as not shaving your legs a week before surgery to avoid nicks in the skin and showering with a special antiseptic the day before surgery.”

Stephanie Custer, a total hip replacement patient, recently attended a boot camp at Jennie Sealy Hospital a few weeks before her scheduled surgery. Her son, Kevin Wood, attended the class with her and said the 90-minute session was well worth their time.

“Before this class, my mom had about a thousand questions, but they pretty much answered them all today,” Wood said.

Custer added, “I didn’t have to ask a question, they covered everything for me. I feel much more confident now and am ready to do this!”

Participants said they appreciated viewing “how-to” videos, which were recently added to the end of the class. The short clips show how to use various assistive equipment, such as how to walk with a walker and how to get in and out of bed.
Since patients are usually only in the hospital for about one to two days, Chapman said providing patients with information on how to successfully recover at home is key. The class includes an opportunity for patients to schedule their outpatient physical therapy appointments at UTMB if they haven’t done so already.

In the future, Rehabilitation Services is looking to add boot camp sessions for patients who have not yet decided to undergo joint surgery, but would like to get more information about the process and hear from UTMB orthopedic surgeons.

“We continue looking for ways to improve the way we serve patients and I always ask participants if the boot camp was helpful,” said Cathy Elton, a physical therapist and boot camp leader. “So far, the feedback has been overwhelmingly positive. It makes us feel really good that we are moving in the right direction and providing Best Care before, during and after surgery.”