Kemptville District Hospital Performing Knee Replacement Surgeries in Innovative Partnership with The Ottawa Hospital

November 30, 2011

Thanks to an innovative partnership with The Ottawa Hospital (TOH), Kemptville District Hospital (KDH) has recently begun performing knee replacement surgeries. The only hospital of its size in Ontario performing total joint replacements, KDH is helping to cut regional wait times for these surgeries, as well as freeing up TOH’s operating rooms for life or death trauma cases.

The concept of a partnership between a large urban teaching hospital and a small-town hospital began to take shape last spring between senior administrative and medical staff. The medical planning for the joint program was led by KDH’s Chief of Staff, Dr. Greg Leonard, and The Ottawa Hospital’s Head of Orthopedic Surgery, Dr. Geoff Dervin who, fittingly, performed the first knee replacement surgery at KDH on October 17, 2011. Dr. Dervin had been performing outpatient orthopedic surgery at KDH since 2006. He perceived an opportunity for the two hospitals to work together to solve the problem of a lack of operating room capacity at TOH, and a backlog of patients waiting for new knees. The partnership is a creative use of wait-time funding, a federal pot of money allocated provincially.

Initiated in 2004, the provincial wait-time fund aims to cut waiting times in five designated procedures: hip and knee replacements, cataract surgery, heart operations, diagnostic imaging and cancer radiotherapy. In order to decompress its operating rooms and get through its waiting list more quickly, TOH was prepared to bring surgeons, patients and wait-time funding to KDH, which would provide the operating rooms, nursing and allied health staff, and inpatient care,

Dr. Dervin was already familiar with the quality of the operating rooms at KDH; his only reservation was the distance – he wasn’t sure that patients would be willing to travel for their surgeries. As it turns out, “Patients love coming here,” he says, “for the amazing patient care.” Kemptville’s proximity to Highway 416 means it’s a short trip from Ottawa. Knee replacement patients are also coming to KDH from Cornwall, Renfrew and the surrounding area.

Building on its own growing orthopedic program, KDH has expanded the knee replacement program to include its own surgeons. Dr. Paul Shim has joined the KDH surgical team to perform additional surgeries. With available operating room space, Shim plans to be busy.

A program addition of this scope has been transformational for KDH. Moving to total joint replacements meant not only a new orthopedic operating room (included four years ago in the design for KDH’s 2010 expansion), but also 12 new beds for inpatients requiring postoperative care, the hiring and training of nurses, and purchase of new state of the art surgical and sterilization equipment...Cathy Watson, Manager of Clinical Programs, explains: “It took the whole building working as a team to make this happen.” Catherine Van Vliet, Director of Patient Services and Integration, agrees, “All staff, from admitting to x-ray, had to be aligned and focused to achieve this progressive transformation.”

TOH was a “remarkable partner” in the process, says Van Vliet, generously providing training for KDH operating room nurses on the procedure, and sharing care pathways and processes. Jack Kitts is the President and CEO of TOH, a complex comprising the General, Civic and Riverside campuses. “This partnership has proven that through integration and collaboration we can improve access to quality care,” he states. Paula Doering, TOH Vice-President, Clinical Programs, adds, “Collaboration by staff at both organizations is a model for how health care organizations can work together.”

With a roster of seven orthopedic surgeons, KDH is offering total joint replacement three days per week, with four surgeries per day. A four-joint day is difficult to achieve for city and country hospital alike, according to KDH’s OR Team Leader, Julie Summers, necessitating the efficient functioning of every member of the team. KDH has a total of three operating rooms running at near capacity now, with two older OR’s under renovation. Shoulder surgeries are also offered at KDH; hip replacements may be available in the future.

“The key to success is a strong team, and that’s what we’ve built here,” states Janet York-Lowry, facilitator for the total joint program. She is the first point of contact with knee replacement patients, conducting a screening interview to determine a patient’s suitability for the program. The patients selected for total joint replacement at KDH are healthy, low risk patients who will be discharged after a two or three day stay in hospital. Pain management is critical in post-operative patient care, and new protocols were required in the shift from day to inpatient surgery, says KDH Charge Pharmacist Mary Whyte. Also key to patient recovery is physiotherapy; recipients of new knees are visited by a physiotherapist within hours of their surgery, and are on their feet the following day. Ice, compression, and elevation help with the swelling, explains physiotherapist Meg O’Brien; if pain and swelling are under control the patient’s walking improves more quickly.

Renie Schonberg was the first patient to undergo knee replacement surgery at KDH on October 17. One month later, she’s finishing physiotherapy and enjoying increased range of motion in her knee...Kemptville District Hospital (KDH) is a fully accredited healthcare facility committed to building healthy communities. KDH offers a range of services based on advanced expertise, technologies and patient care practices. Its emergency department is open around the clock and provides prompt medical attention. The Hospital's use of new medical applications such as Tele-health and remote diagnostic imaging has made KDH a service leader in Eastern Ontario. Further, its surgical program provides timely access to high demand specialists, while its staff's dedication to patients has earned KDH a reputation for excellence in caring. KDH consistently ranks among the top hospitals in Ontario for patient satisfaction.

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