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Overcoming barriers to short stay joint replacement programs

4 Jul 2023, by Amy Sarcevic

Short stay joint replacement programs are increasingly being talked about in healthcare, as forecasts for the surgery blow out to unsustainable levels.

Statistics show that the lifetime risk of knee replacement in Australia is 1 in 5 for women and 1 in 7 for men. If this trend continues, the number of procedures is predicted to rise by 276 percent by 2030. The projected cost of this is upwards of $5billion, more than $3billion of which will be funded by the private sector.

Add to that the challenges of an ageing population and the after-effects of COVID restrictions on elective surgeries, and our capacity to meet this growth seems unachievable without serious reform.

Professor Ilana Ackerman of Monash University says short stay programs – also known as ‘fast track’ or ‘rapid recovery’ programs – offer hope, but acknowledges there are still some major barriers to their implementation in Australia.

“Short stay programs have now been used successfully in many different countries, but they are less common in Australia. If we want to roll them out more widely, then we need to address some of the knowledge gaps in this space,” said Prof Ackerman ahead of her presentation at the Short Stay Hospital Forum.

Filling in the gaps

To fill in the knowledge gaps, Prof Ackerman and team at Monash University, together with her collaborators, recently completed a major research project.

Funded by an HCF Research Foundation Innovation Research Grant, the project sought to expand the evidence base around the safety of short stay joint replacement programs and offer guidance to new fast-track initiatives.

The research consisted of three components, Prof Ackerman explained.

“The first component involved a systematic review of contemporary evidence around safety outcomes and optimal patient selection for short-stay joint replacement programs. We already know that these programs aren’t appropriate for all patients, but there is currently little evidence to help guide clinicians in their decision making.

“The second component was a national stakeholder survey, focusing on clinicians, hospital administrators, patients and carers. This looked at the acceptability and feasibility of short-stay programs, current practices, as well as the perceived barriers and enablers.

“Thirdly, we did a budget impact analysis to examine the potential cost savings and other financial impacts that could be achieved by rolling out this model more broadly.”

The research, which was completed earlier this year, provided data on the potential economic value of short-stay programs, including savings in bed days, and increases in surgical throughput.

“It has helped us better understand the opportunities and challenges around short-stay programs, and identify what needs to be addressed in our healthcare system to implement these programs more widely in Australia.

“We now have detailed insights from multiple stakeholder perspectives into the factors affecting implementation and sustainability, and better understand the resources needed to support a national rollout.”

Ilana Ackerman is a Professor (Research) in the School of Public Health and Preventive Medicine at Monash University and a Deputy Director of the Musculoskeletal Health Unit. She is a musculoskeletal epidemiologist and an experienced orthopaedic physiotherapist. Her research findings have been published in leading international orthopaedic surgery, rheumatology and physiotherapy journals and she has received a range of research awards for her work.

Talking more about her research Prof Ackerman will present at the Short Stay Hospital Forum, hosted by Informa Connect.

She will be joined on stage by representatives from Centuria Healthcare, Nexus Hospital, HIVE Legal and Medibank, among others.

This year’s event will be held 1 August at the Rydges Melbourne.

Learn more and register here.





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