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Case Study at Wrexham Maelor Hospital

Improving the patient pathway at Wrexham Maelor Hospital

Since 2008, staff at Wrexham Maelor Hospital have been committed to improving both the quality and efficiency of care provided to patients undergoing arthroplasty surgery, by implementing a scheme to improve patient outcomes, increase patient and staff satisfaction, reduce post-op complication rates and reduce length of stay and thus costs.  Consequently, the Rapid Recovery Programme has been designed to optimise all aspects of the patient’s journey from pre-operative assessment through to, and beyond discharge, with an aim to enable a quick yet safe recovery from knee replacement surgery.


Since introducing Rapid Recovery to Wrexham Maelor Hospital the length of stay (LoS) has almost halved, decreasing from 6 days to an average of 3.1 days, patient outcomes have improved, staff and patient satisfaction scores have increased and both early complication and subsequent readmission rates have reduced.


The hospital has experienced significant cost savings relating to the decreased LoS and reductions in post-operative complication rates, meaning more patients are able to experience this life changing surgery.  Another benefit of the programme has been the way in which it has improved team dynamics.  By involving all disciplines throughout the patient pathway, using a multidisciplinary approach, the team has become far more integrated, less hierarchical and as such are more cohesive.

As they are now acknowledged as a European Centre of Reference, Wrexham Maelor’s profile has also been raised significantly and the team are now hosting visits from interested parties across Europe and are involved in promoting the programme nationally in Wales.

In July 2011 the Orthopaedic Rapid-Recovery team at Wrexham Maelor Hospital was recognised for their pioneering work in radically redesigning its Arthroplasty pathway by winning the NHS Wales Award 2011 in the category of ‘Improving Quality through the Better use of Resources’.  This was the culmination of 18-months dedication on a programme of work delivered through bottom-up change, requiring a fundamental change in the traditional model of arthroplasty care.

This is just the beginning for Wrexham Maelor Hospital; they plan to continue developing other pathways which will improve the care of their Orthopaedic patients and the hospital has introduced hip replacements and revision surgeries into the Rapid Recovery programme.  The main emphasis now is standardising the new elective pathways across North Wales, whilst commencing a Rapid Recovery programme across North Wales too.


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