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Case Study at Hillingdon NHS Trust



"The patient satisfaction has dramatically improved as has staff morale."

David McVittie

CEO at Hillingdon & Mount Vernon NHS Trust

Changing Practice at Mount Vernon and Hillingdon NHS Trust.

Hillingdon wanted to change the way that patients, undergoing hip and knee surgery in the Mount Vernon and Hillingdon NHS Trust, were cared for. They wanted to ensure that their patients received a quality service which put the patient first, resulting in clear benefits in terms of recovery and a return to a normal life.

The team felt that that the pathway was fragmented and each discipline was independent of the other. They were looking for a far more joined up process that ensured their patients were treated in an effective and efficient manner.

They were mindful of the impending move to their own treatment centre planned for February 09 and wanted to ensure that they adopted an efficiently run service from the start.

The surgeons knew that the Rapid Recovery Programme  with its proactive approach to joint replacements would help them to deliver the standard of care that they wanted in their own Trust.

A multidisciplinary team worked together for six months adapting the programme for each step of the patient’s journey. They mapped out the service that they were currently delivering and then worked together to map out the pathway that they would ideally like to deliver. Working groups then developed strategies for ensuring each objective could be met. This resulted in a streamlined pathway of care that had input from all disciplines. Each step of the pathway has demonstrable benefits to the patient and the Trust and time wasting for both the hospital and the patient is eliminated.

The patients are encouraged to take an active part in their care and include their family and friends in this process. The patients are more confident of their treatment and have fully embraced the new way of delivering their care.

The patient satisfaction has dramatically improved as has staff morale. Early results show that their LOS has reduced to a median of 4 days and a mode of 3 days. The majority of patients leave the hospital on day 3 and they leave in the same optimum condition as they would have previously on day 5 or even longer. The unique “prehabilitation” of preparing the patient for surgery prior to admission and robust preadmission and planned discharge services ensure that there are no avoidable delays to their discharge. They have also seen a revenue increase as well as an increase of out of area work. This means that more patients in the location will be able to experience this life changing surgery.

This is just the beginning for the Trust; they plan on looking at improving the early results further and developing other pathways which will continue to improve the care of their orthopaedic patients.


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