Hundreds of people a year needing total knee or hip replacements or spinal surgery, who might have made the trip to New York City, may choose instead to visit HSS Orthopedics at Stamford Health, a new surgical unit at Stamford Hospital.
A ribbon-cutting ceremony took place Oct. 30 to celebrate a collaboration between the Hospital for Special Surgery and Stamford Hospital. A previous collaboration by the two hospitals introduced a sports rehabilitation facility at Chelsea Piers and outpatient surgery at the Tully Health Center.
The new 40,000 square-foot unit encompasses the entire fifth floor of the new hospital, with two operating rooms, four pre-op beds, a 12-bed recovery room, 19 inpatient rooms and a rehabilitation gym. Approximately 50 staff are being hired to care for patients, the first of whom are scheduled for Monday, Nov. 6. As many as 1,200 to 1,500 are expected to be treated as in-patients in the hospital or out-patients at the Tully Health Center.
At the ceremony, Brian G. Grissler, president and CEO of Stamford Health said he is pleased with the working relationship he’s developed with Louis A. Shapiro, president and CEO of the Hospital for Special Surgery (HSS).
“We recognized the new Stamford Hospital provided an outstanding opportunity for a unique collaboration that would add internationally recognized orthopedic expertise to our existing programs here at Stamford,” he said.
“HSS was a perfect partner to create a premier center for advanced orthopedic care. They are the world’s leading academic medical center focused on musculoskeletal health and lead the field of orthopedics nationwide for successful outcomes and lowest infection, complication, and revision rates.”
“Patients come to HSS from all 50 states and almost 100 countries every year,” Shapiro said, adding the hospital was seeking to offer care not only in Connecticut but the broader New England region as well. “As we were considering the Connecticut market I was struck by the commitment of Stamford Health and their philosophy of care and their reputation for quality.”
Dr. Charles Cornell is chair of the newly formed Department of Orthopedic Surgery at Stamford Health. He led guests on a tour of the floor and explained some of the thinking behind the design.
For example, having four pre-op rooms enabling four patients to be seen at a time saves time and allows them to be wheeled directly into an operating room that has been specially designed for joint replacement surgery. While there are two fully functional operating rooms at present, there is room for several more to be added.
“Everything has been designed to prevent infection,” he said. Noting that the room temperature is in the low 60s, he explained “cold means clean.” A constant flow of air moves down from the ceiling, passes under a series of clear panels that reach almost ceiling to floor, and out. Surgeons wear “space suits.”
A series of large wall monitors can display a variety of information from a patient’s consent form and electronic medical records to X-rays. Images from surgery can be displayed on the screens and transmitted for teaching purposes.
Robotic surgery is sometimes used in orthopedic procedures and the “robot” can be brought into the operating room as needed.
The team that would work in the spacious operating room for a typical hip or knee replacement would include a care nurse, unit anesthetist, attending surgeon, anesthesiologist, two physicians’ assistants, and a surgical technician.
Once surgery is completed — which may take as little as two hours for knees and hips, three to four hours for spinal cases depending on the complexity — patients are brought on the O.R. bed down a corridor to the post-acute area, more commonly known as the recovery room. Here, beds are designed to allow radiographs to be taken in bed. Patients spend about three to four hours here, Dr. Cornell said, and this is where physical therapy usually starts.
“Our goal is to have a patient walking within six hours of surgery,” he said.
Patients are then discharged to their rooms, each of which is private with its own bathroom and large windows. The bathrooms feature a shower that drains right into the floor with no sill for patients to try to step over.
While physical therapy often takes place in a patient’s room, there is a “gym” where people may practice walking up and down stairs. Eventually a driving simulator will be installed to help patients work on getting into and out of a car.
The nurses’ station has a large wall monitor that tracks the care program for each person who is admitted.
Patients won’t be spending much time at the new surgical unit. According to Dr. Cornell, the average stay for a total hip or knee replacement is two days. Younger or healthier patients, he said, “will have their first post-op day at home.”
Stamford Health provides inpatient, outpatient and ambulatory services through Stamford Hospital, a 305-bed acute-care tertiary hospital that opened a year ago, replacing a previous facility. Information: StamfordHealth.org.
Hospital for Special Surgery is an affiliate of Weill Cornell Medical College. Information: hss.edu.