Tuesday, January 20, 2009

Joint replacement center certified for excellence

(At right, Dr. James Ramser has a word with Robert Wheeler before his total knee replacement surgery recently.)

Rodger Baker, CEO and president of Fauquier Health, announced last week that the Fauquier Health’s Center of Excellence for Joint Replacement has been awarded a Certificate of Distinction for its commitment to excellence. The Joint Commission -- the oldest and largest accrediting agency for hospitals nationwide – presented the honor.
The certification was awarded after an extensive study of the center, its clinical procedures, documentation policies, patient satisfaction and patient outcomes.


Former patient Carol Gilliam wasn’t surprised when she found out about the recognition. She has experienced the center’s excellence firsthand – twice.


Gilliam first started to notice the pain in her knees in 2001. At first she was able to manage it with over-the-counter pain medication, but by 2004 her pain had progressed significantly. On a much-anticipated trip with her husband to California, Gilliam was in so much pain that she was unable to leave their hotel room.

That trip convinced Gilliam to tell her physician that she was ready for a permanent solution. She met with Dr. James Ramser of Blue Ridge Orthopaedic and Spine Center, and some of the Fauquier Hospital Joint Center staff to discuss the surgery. They told her what to expect and what she would need to do afterward to have the best outcome.

In January of 2005, Dr. Ramser performed the joint replacement on Gilliam’s most painful knee. Gilliam said, “A successful surgery is the first step of course, but I am a retired nurse so I know how important it is to follow your recovery program. They told me I would need physical therapy and that I would need to do everything they told me to do.”

It wasn’t easy, and it was painful, but Gilliam was so happy with the results that she soon scheduled surgery for the second knee. Looking back, she has no regrets. “Three months after my second surgery I traveled across the country with no problems, and then we went to Germany and I walked everywhere, even up and down lots of steps.”
Gilliam’s husband, Frank, said, “Carol got her life back and I got my wife back”

The journey to the Center of Excellence designation did not happen overnight. Blue Ridge Orthopaedic’s Dr David Snyder took the role of physician champion in 2004 and guided the hospital’s center of excellence development team through nearly five years of progressive changes. A physician champion is a doctor who works with the hospital on behalf of patients, making sure that the interests of the patient are always at the forefront. Dr. James Ramser who recently joined the team as an enthusiastic champion, said, “We serve as advocates for the patients.”

Dr. Ramser said that in the five years since the Center of Excellence initiative first began, the process of care has improved dramatically. “Years ago, before we started to use the center model, everyone did his or her own job but it was more about the mechanics of getting the job done. With the center concept, everyone is part of a bigger team. Now, everyone from the physician, to therapist, nurses and cleaning staff are all focused on one thing – to have a happy patient with good outcomes. It is a huge step forward and it is great to have official recognition from the Joint Commission.”

Dr. Ramser points to the best technology as another contributor to successful outcomes. “For example, the recently adopted Brain Lab is world-class technology for precise, three-dimensional information during surgeries.” Brain Lab is computer-assisted surgery – sort of a GPS system for joint surgeries.

Dr. Ramser is especially proud of the hospital’s track record in infection control. “A frequent concern in all hospitals is always the chance of infection during surgery, which can never be completely eliminated. But our current rate is extremely low, about one third of one percent, which is far below the national average.”

Carol Gilliam offers advice to those considering joint replacement: “If your doctor says you are ready and if you are ready to commit to what you need to do, then joint replacement could be the best decision you ever made.”

When to consider joint replacement

How do you know if you are ready for knee or hip replacement?


Orthopedic surgeon Dr. David Snyder said, “Most people think pain is reason enough, but it isn’t necessarily. Many people can lead complete and fulfilled lives with some pain, perhaps controlled by medication.” He said that there are three reasons to consider joint replacement – when you have:

• Incapacitation – you are so disabled by the pain that you are unable to enjoy a satisfactory quality of life.

• Unsafe knee – your knee gives way at unexpected times creating a dangerous situation that could result in serious injury, like a broken hip.

• Sleep deprivation –you are so uncomfortable that you don’t sleep; sleep deprivation is a serious health concern that should be addressed.

Dr. Snyder regularly discusses everything you need to know about joint replacement in his free lectures at Fauquier Hospital. The next lecture will be at 6 p.m. on Thursday, March 19. The sessions are held in the hospital tower Sycamore rooms at Fauquier Hospital.

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