Surgical techniques, improved and personalized preparation for surgery, and patient optimization pre-operatively have led to the length of stay for total joint replacement patients to gradually decline from nearly a week to under twenty-four hours in the past thirty years. Over the past ten years, Angela DeVanney and the goShadow team have worked alongside orthopedic surgeons, such as Tony DiGioia, MD, Medical Director of the UPMC Magee Bone and Joint Center and UPMC Innovation Center, to pioneer person-centered approaches that deliver top-quintile patient experience scores; unparalleled operational efficiency in the inpatient, surgical, and outpatient settings; and a same-day total joint replacement program that has nearly zero readmissions.

While pioneers like Tony DiGioia will attest that surgical techniques have partially enabled the advent of same-day total joint replacement programs nationally, they would attest that the key component is the personalized preparation and education for patients and families. Angela and the goShadow team support UPMC and the Bone and Joint Center in this effort through patient shadowing, journey mapping, and collecting qualitative data. Systematically and iteratively collecting quantitative and qualitative data throughout the months-long patient journey provides opportunities for interdisciplinary team projects and action plans based off of real-time patient and staff-reported feedback. 

Hardwiring these opportunities for leaders, clinicians, and care teams to connect with each other and patients brings joy and satisfaction to their work, as evident by an overwhelming number of employees having multi-decade tenure in positions ranging from front office receptionist to operating room nurse. 

Recently, the UPMC Bone and Joint Center and Operation Walk Pittsburgh hosted a patient reunion for the past three years of surgical patients to reconnect with one another. This event provides another opportunity to collect feedback from patients in order to continuously improve other patients’ experiences.  In 2019, the feedback collected was used to re-design the patient education pathway and to develop gender-specific interventions pre- and post-operatively to optimize outcomes– leading to the same day total joint replacement program. Interestingly, nearly one hundred percent of the time, the feedback surprises providers and care team members because of its non-technical nature. Instead, feedback uniformly requests easy-to-do interventions, such as pre-habilitation therapy, that can be done at home; advanced teaching and what to expect at each step of the pathway; and connecting with another patient who has had surgery to ask questions and to gain support. 

In 2022, the same two simple questions were asked of the hundreds of attendees and their families: “What do you wish that you had known prior to having surgery?” and “What advice would you give to another patient about to have surgery?”. 

goShadow analyzed the results to give feedback to care team members and to patients what was said. Nearly 50% of responses requested information related to patient education prior to surgery. Nearly 40% of responses advised future patients to do physical therapy–before and after surgery.

‍

‍

Continuous improvement is in the bones of the tens of care team members and tens of thousands of patients who are part of the UPMC Bone and Joint Center. Acting from the recent data, shadowing teams are being deployed throughout the patient pathway to deep dive into opportunities and pulse surveys are administered to staff and patients to gain additional ideas for how to co-produce change.  Learn how goShadow’s dynamic trainings, tools, and strategy can support your organization.  

Listen to Dr. Tony DiGioia and Jessica Carlson, RN discuss this and other innovations on goShadow’s upcoming Summer Speaker Series.  Learn more and register today.