Expert Care Amid COVID-19
At the onset of the COVID-19 pandemic, when AMITA Health St. Alexius Medical Center Hoffman Estates identified some of the very first COVID-19 patients in Illinois, the U.S. Centers for Disease Control and Prevention (CDC) established a field office in the hospital's conference room space. Working in close collaboration, CDC and AMITA Health officials developed a comprehensive, systematic program to effectively address infection risks at the hospital. As such, the medical center was one of the first in the state to establish guidelines created with the CDC including visitor restrictions, personal protective equipment, social distancing implementation, rigorous disinfection measures, staff testing, patient screening, and much more.
Establishing a COVID-free zone: Unlike most orthopedic centers in Illinois, the AMITA Health Center for Advanced Joint Replacement (CAJR) Hoffman Estates is physically separated from other units in the hospital. This allows the medical staff to function as an integrated team that focuses exclusively on joint surgery patients in an isolated setting. In addition to the system-wide safety measure, the CAJR team implemented several additional safety measures specific to joint replacement surgery:
- Patients are tested for COVID-19 three days before their surgery and asked to self-isolate prior to arriving at the hospital for a procedure. Hospital staff greet every patient at the entrance to the hospital to check for symptoms and potential exposure to COVID-19. Joint replacement patients scheduled for surgery are taken to an elevator specifically reserved for patients headed to the 2nd floor, which is used exclusively by the CAJR team.
- Patients stay on the 2nd floor, which is entirely dedicated to joint replacement surgery, until he/she is ready to go home; pre-surgery, the operating room, recovery area and rehabilitation gym are all within the CAJR unit.
- No other patients or non-CAJR staff have access to the 2nd floor. These strict safety protocols help ensure a COVID-free zone and provide patients in need of joint replacement surgery much needed peace of mind. Since the reopening in May, the CAJR has successfully performed over 300 surgeries through the month of August.
“As a physician, my first Director of AMITA’S CAJR responsibility is to do no harm. If I thought it was dangerous in any way for patients to come to our hospital, I'd stop doing surgeries,” said orthopedic surgeon Paul S. Nourbash, MD, Medical Director of AMITA’s CAJR. “But I am fully confident that things are safe, and we can give patients even more attention because of the design of our center of excellence.”
A case in joint replacement: Joan Banaszak of Itasca received her first artificial joint for her right knee at CAJR in 2019. The procedure performed by Dr. Nourbash was a welcome success. At the time, she knew her left knee would also need to be replaced one day. That day arrived in early 2020.
“The persistent joint pain really interfered with my daily activities. I couldn't do much of anything,' Banaszak recalled. “When I was emptying the dishwasher, I had to sit down. If I put in a load of clothes, I'd have to sit down. I couldn't walk around the block. I had no quality of life.”
Banaszak underwent her second knee replacement surgery at CAJR as soon as elective procedures were again allowed in Illinois. “When Dr. Nourbash reassured me that everything possible was being done to make sure everyone is safe, I was ready” recalled Joan. “I got my new left knee in June.'
“We take our responsibility to manage the COVID-19 situation very seriously. We stay very current on the best practices in the world,” said Polly Davenport, senior vice president and regional operating officer for AMITA Health's Northwest region. “We want to make sure that our patients and our associates stay healthy!'
CAJR nurses, dedicated exclusively to the care of joint replacement patients, also have expressed comfort knowing that they are working in a COVID-free zone. With the anxiety of contracting the virus eliminated, nurses are more relaxed when caring for their patients.
Returning patients home sooner with computer-assisted technology: All orthopedic surgeons at CAJR are fellowship-trained in joint replacement operations with expertise in computer-assisted surgery. Dr. Nourbash has performed computer-assisted surgeries for more than 15 years, and currently uses the MakoTM Robotic-Arm Assisted Surgery system for all his partial and total knee replacements.
'Computer-assisted operations can make good surgeons great, and great surgeons can become extraordinary,' said Ms. Davenport. “Dr. Nourbash helped me understand the benefit of added precision during these incredibly exacting operations, so we made a decision to be on the front end of this technology and have made significant investments to bring it to our communities.'
Significant COVID-19 outbreaks in the nation's rehabilitation centers and nursing homes have resulted in patients seeking shorter stays at in-patient facilities or receiving physical therapy sessions at outpatient clinics. The shift is dramatic. “Four years ago, nearly half my patients were going to a rehabilitation facility where they lived and received their therapy,' said Dr. Nourbash. “Now, less than 6% go to an extended care facility.”'
Patients who want to return home just hours after their surgery can do so if they meet the criteria for same-day discharge. The vast majority of CAJR patients stay less than 36 hours at the St. Alexius Medical Center. The road to recovery starts at the CAJR rehabilitation gym where AMITA Health therapists help patients simulate common daily activities in the bathroom, kitchen, staircase, and customized therapy car with adjustable seats to prepare them for their daily lives at home.
After Banaszak had her second total knee replacement operation in June, she received seven weeks of outpatient physical therapy. By August, she reported both knees were doing well. “I so appreciate the care and kindness that Cara Dusza - my physical therapist after both knee surgeries - showed me.' Banaszak said. “Cara helped get me to where I can do things at home, get in and out of a car, go to the grocery store and to a restaurant with Bob.'
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