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Video Interview

Mr Houlihan-Burne



What is the main reason for introducing the Rapid Recovery programme in your hospital?

The main reason for introducing Rapid Recovery was that in the past, the treatment of patients having hip or knee replacements has been fairly random, inconsistent and outcomes have been acceptable, but not excellent. The Rapid Recovery programme allows us to raise the bar on the expectations for our patients and for ourselves. By introducing the programme we’ve significantly increased our patient satisfaction and our functional outcomes for our patients having hip or knee replacement.


What have been the key benefits to you and Hillingdon hospital?

The key benefits are a multitude. You can split the benefits up into the benefits for the patient, then the benefits for myself as a surgeon, the benefits for the whole of the multi-disciplinary team at Hillingdon and finally the benefits for the trust themselves. For the patients, obviously the benefits are a earlier discharge from hospital with an earlier return and an achievement of the functional milestones that used to take six to eight weeks, patients now go home in two to three days and are back driving and back to work much quicker. The benefits for myself are that I have much happier patients, who recover more quickly and have lower complication rates. The benefits for the team is that it’s empowered the multi-disciplinary team, we now work together as a group very much more than we used to, we know each other by name, we meet regularly and we have introduced standardisation which makes life much easier for everyone from the theatre porter, to the ward nurse, the anaesthetist and surgeon. And finally for the trust, there are quite clear financial benefits in reducing lengths of stay, reducing the time a patient needs to stay in the hospital and clearly this translates into financial benefits for the trust.


What challenges have you encountered in implementing the programme?

The challenges really are creating a team to work together, traditionally in the United Kingdom, the individual specialities that work, such as anaesthetists and surgeons work on their own, they provide their own service without a lot of communication. The difficulty was getting these people together to discuss the best plans for the patients and to all work in the same direction, giving the same message to the patient and being consistent about what we are doing. Once you can achieve that with an individual, then everyone else comes on board and the whole department will then adopt the Rapid Recovery programme.


How would you recommend colleagues to start with the RR programme?

The Rapid Recovery programme is a philosophy. It has many facets to it and is a bit like a jigsaw puzzle and unless you have all of those pieces together, the programme will not work. However, when your starting out you want to start out with small things first, the changes that you can make, that are easy to make and you do it as an individual you can then make those changes and something we call “the viral spread of change” where colleagues and other trusts around will see the changes you’ve made, step-by-step the improvements that occur and quite clearly benefits and the outcomes can be seen by everyone.

<< Back to Rapid Recovery Symposium page


Video Information

Interview with Mr David Houlihan-Burne, Consultant Orthopaedic Surgeon

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