Editor’s note: This is part of an ongoing series looking at the past, present and future of MidState Medical Center, which opened in Meriden 20 years ago next month.
MERIDEN — After knee replacement surgery, patients are up and out of bed within hours, and usually discharged home the next day.
The Connecticut Orthopaedic Institute at MidState Medical Center is considered a hospital within a hospital, designed by doctors to help patients in need of joint, hip, back or disc surgery reduce recovery time and get back on their feet faster.
“These patients come from all over the state,” said Gary Havican, president of MidState Medical Center and the Hospital of Central Connecticut. “We actually do classes prior to surgery. All of our readmission rates are low. They know what to expect ahead of time.”
The 14,500-square-foot center in Pavilion A was remade last year into a $12 million center with dozens of surgeons, 21 patient rooms, 11 operating rooms, and a rehabilitation center.
It was created by orthopedic doctors who wanted to improve access to specialized care, Havican said. As surgical techniques streamlined recovery, Connecticut Orthopaedic Specialists joined Comprehensive Orthopaedics, the former orthopedic center at MidState, to form the institute.
Nationally, the number of hip and knee replacements performed has doubled in the last decade. These procedures have also become more common in younger patients as well, further increasing the demand for not only these procedures, but surgeons to perform them.
The institute has hired only certified, trained and experience nurses, physician assistants and physical therapists. Surgery is done in suites located on the unit.
“We work as a team,” nurse manager Cathy Mangini said. “It’s not just one person who makes this unit. Every one of us works together. We have very specific things that we do.”
Patients are out of bed within hours of surgery. The team gets them up at 5:30 a.m., washed and dressed in their own clothes because it makes them feel better, Mangini said. Physical therapy sessions begin at 7:30 a.m.
The rehabilitation center is designed to help patients walk, climb stairs, and even drive — there’s a stationary car with a swinging door to practice getting in and out.
A phone navigator contacts patients before surgery to prepare them for their stay and for post-operative care. Patients are generally discharged a day and a half after surgery. A small percentage require more than one night, Mangini said.
The physicians purchase a single rose for every patient.
There is a ribbon of motion throughout the rehabilitation room. The walls are decorated with colorful photos of hikers, boaters and runners navigating Connecticut’s landscapes. A series of outlines of former patients participating in sports or activities are featured on the walls of the physical therapy room.
Havican said the institute is part of the future of medicine, where specialists converge to design the ideal settings for rehabilitation and recovery. The Orthopaedic Institute is among the first of such specialties the Hartford HealthCare network will pursue at MidState and other hospitals.
Other health care networks have also opened specialized services for joint, bone, and orthopedic care.
Trinity Health of New England operates a sports medicine institute, a joint replacement institute and a spine institute, which provide inpatient surgery and recovery as well as outpatient services on site. The Trinity Health of New England group is a partnership with St. Francis Hospital and Medical Center and Mount Sinai Rehabilitation Hospital, both in Hartford; Johnson Memorial Hospital in Stafford Springs; St. Mary’s Hospital in Waterbury; and Mercy Medical Center in Springfield, Massachusetts.
“I don’t think it’s unusual,” said Susan Schaffman, executive direcor of the Connecticut Orthopaedic Society. “It’s focused, a pretty comprehensive center.”
According to a 2016 article from ModernHealthCare.com, more hospitals are starting to move joint replacement into outpatient settings to compete with free-standing ambulatory surgery centers.
“The smart, strategic hospital management teams understand they need to get ahead of this, so that when volume shifts out of their buildings they won’t lose patients,” Brian Tanquilut, a senior health care analyst at Jefferies & Co. told the publication.”That’s why the investor-owned hospital companies are making a big push on surgery centers.”
Dr. Robert Green, who practiced at St. Francis Hospital for 40 years, recalls when orthopedic surgeons there and at Hartford Hospital gathered to examine patient outcomes and best practices that would establish the Joint Replacement Institute at St. Francis.
“Doctors working together can provide better quality care if they work for the greater good of the patient overall,” said Green, who was a past president of the Connecticut Orthopaedic Society. “The concept in establishing these centers is quality patient care at reasonable prices. The hospital provides a quality facility and the physician provides expert quality care based on evidence-based medicine and the standard of care.”
This is a model for the future, Havican said. “We want to develop this model. We have developed this after orthopedics, but we really want to roll it out among other specialties. Compare this to any institute in the nation and we have exceeded all expectations.”