The SwiftPath Program emphasizes patient education, the use of minimally-invasive surgical (MIS) techniques, reduction in narcotic use, use of modern pain management and early mobilization. SwiftPath is constantly working to enhance the experience and recovery for patients and their families in both inpatient and outpatient joint replacement settings. Although individual results will vary, many SwiftPath patients report return to routine and daily activities by 3-4 weeks! In addition, MIS techniques and the SwiftPath method contribute to smaller incisions, less complications, less pain and better early function.
SwiftPath surgeons and the SwiftPath Program is of the highest quality. SwiftPath Surgeons study minimally-invasive techniques and are certified in performing periarticular injections. They engage in high levels of training and education in the area of patient safety. You will receive a detailed Patient Guide, authored by your surgeon, that will act as your road-map for the entire surgical and recovery experience.
SwiftPath Surgeons utilize an online cloud-based platform to follow your care at home after surgery. This platform helps your surgeon follow your progress and continue to make improvements in the program.
A critical part of the SwiftPath Program is focused on evaluating and improving the patient’s pain after surgery. Central to SwiftPath is the patient experience and pain management. In a recently published series, SwiftPath patients reported a very high level of satisfaction with their pain control.
All SwiftPath patients receive periarticular injections during their joint replacement surgery. Your SwiftPath Surgeon will inject numbing medicines to specific nerve zones surrounding the knee and/or hip. The use of numbing medicines around the joint have been shown to decrease postoperative pain, especially when used in combination with MIS techniques.
The SwiftPath Program emphasizes both the prevention as well as the treatment of pain within its pain management protocol and is constantly analyzing and reanalyzing improved methods of the multimodal pain management. Pain management is a complex combination of cold therapy (icing), use of multimodal pain management (such as anti-inflammatories), and the occasional use of narcotics.
SwiftPath patients are educated on the SwiftPath Method of multimodal pain management and are empowered to manage their pain during their recovery at home. In addition to patient education, SwiftPath Surgeons continually monitor their patients’ self-reported outcomes through the online cloud-based patient-monitoring platform.
The SwiftPath Method allows for outpatient, overnight stay and the occasional longer hospital stay. You and your SwiftPath Surgeon will determine the best pathway for you based on potential complications, risks, your level of understanding with postoperative care, and overall preparedness.
Inpatient joint replacements take place in a hospital where you will stay at least one night (overnight stay or shortened hospital stay). Historically, all joint replacements were done as inpatients due to the large incisions, significant blood loss, significant pain management issues, and a wide variety of complications involved. For that reason, it’s always been felt that joint replacement patients needed to be in the hospital.
Now, with minimally invasive surgical techniques, sophisticated periarticular injections, multimodal pain management, and computer navigation, patients are able to go home on the day of the surgery and do not require hospitalization. This is considered outpatient joint replacement surgery and has significant advantages in terms of decreased pain, decreased complication risks, improved patient satisfaction, and decreased exposure to the potential for hospital-acquired complications and infections. Outpatient joint replacement surgery can occur in hospital outpatient departments or in Ambulatory Surgery Centers (ASCs).
Historically, all patients having joint replacements have been admitted to hospitals and have followed the same clinical pathway regardless of their age, health status, and risks. Little or no attention was focused on matching low-risk patients to more accelerated pathways. SwiftPath focuses on reserving the intensive resources of our hospitals for the patients who truly need them.
To further ensure the best patient experience, the SwiftPath Method utilizes predictive analytics to determine the best pathway for success based on individual characteristics. The SwiftPath predictive analytics are based on a series of answers that you provide to questions regarding your attitude toward pain, hospitalization, nursing care, family support, education, and general understanding of postoperative care. This data is then combined with your individual BMI (body-mass-index) information, scores from your preoperative physical therapy visit and an index score dependent on any individual factors that may increase your risk. You and your SwiftPath Surgeon will determine the best pathway for you.
All SwiftPath patients receive periarticular injections during their joint replacement surgery. These injections are performed by their certified SwiftPath Surgeon using the zonal method to inject numbing medicines (typically a combination of liposomal bupivacaine and standard bupivacaine). Utilization of the zonal method ensures the SwiftPath Surgeon injects the numbing medicine only to specific nerve zones surrounding the knee and/or hip.
The use of slow-releasing and long-acting numbing medicines around the joint have been shown to decrease postoperative pain, especially when used in combination with minimally invasive surgical methods. The use of slow-releasing and long-acting numbing agents can postpone postoperative pain for about 3 days after your joint replacement surgery.
Whether you are having the joint replacement or a caregiver, you have a job.
The job begins with proper preparation and education about the aspects of care that are dependent on the patient. A well prepared patient connected with the right surgeon and the right pathway is the ideal.
The informed patient is a safer patient. You and your caregiver will attend an interactive SwiftPath JointCamp prior to your surgery. You will review all potential risk factors, the benefits of modern pain management, the role and expectations of your caregivers and answer any questions or concerns regarding your upcoming surgery date. Here, you will also receive a SwiftPath Patient Guide that was authored by your SwiftPath Surgeon, specifically for you. This Patient Guide will serve as a personal workbook and comprehensive roadmap. Please bring this Patient Guide with you to all appointments thereafter (i.e. preoperative visit, physical therapy, labs, etc.).
Lastly, it is important to stay in contact with your SwiftPath Surgeon and team following your joint replacement surgery. As always, be sure to call 911 with any emergencies. Also, it is important to use the standard methods for reaching your doctor and the surgical team if you have concerns or questions. Please ask your surgeon and/or refer to your Patient Guide if you are unsure of the standard methods. Additionally, you will input your self‑reported outcomes through the online cloud-based patient-monitoring platform. You will receive instructions for the online registration in your SwiftPath Patient Guide. This direct self‑reporting system will help keep your SwiftPath Surgeon up to date on your progress.
The goal of the SwiftPath Method is to treat the whole patient. To do this, it is important to identify and optimize pre-existing medical conditions that can impact your surgical experience.
The Patient Optimization Program places emphasis on your job as the patient. Your active participation is one of the most important keys to surgical success. In addition, it is important that the patient helps to optimize any medical conditions that can influence the outcomes of surgery. Preoperative optimization means identifying and managing health issues in an effort to help avoid complications. Identifying and treating medical issues early helps get you moving more quickly, reduces time in the hospital, decreases infection rates and other known complications, and decreases the risk of readmission.
Rapid Rehabilitation is premised on the fact that the sooner patients are mobilized after surgery, the better they do. Rapid Rehabilitation is an integral component of the SwiftPath Program. This program has been proven to minimize length-of-stay in the hospital, improve postoperative outcomes, and reduce hospital readmissions.
Rapid Rehab begins with mobilization in the recovery room as you progress to chair transfers, ambulation (walking), and climbing stairs. It then progresses to outpatient physical therapy where the emphasis is on gait, balance, strength and pain control.
SwiftPath Surgeons follow these qualifications:
- Maintaining a certain caseload of joint replacement patients per year.
- Specialty training in SwiftPath Methods.
- Active participation by surgeon and patient on the online patient‑reporting and patient-monitoring platform.
You will be advised to use an Incentive Spirometer after your surgery. Surgery and anesthesia can contribute to decreased lung expansion, fevers and pneumonia. An incentive spirometer is a simple and inexpensive tool that helps keep your lungs healthy after surgery and minimize your risk for pneumonia. You are encouraged to practice using the Incentive Spirometer at home in preparation for your visit as you will be using this tool regularly while in the hospital directly after your surgery.
For instructions on how to use an incentive spirometer, watch our video here
To use the Incentive Spirometer, follow these steps:
1. Sit up as straight as possible in bed, on the edge of your bed or in a chair.
2. Hold the Incentive Spirometer upright with the flow indicator facing you (the “Good, Better, Best” label). Make sure to stretch-out the mouthpiece tube as much as possible. Exhale fully before you begin.
3. Place the mouthpiece in your mouth and seal your lips tightly around it.
4. Begin to breathe in as slowly and deeply as possible. This will raise the piston in the main chamber. Try to keep the flow indicator in the “Better” or “Best” position throughout the entire breath. The marker tab will be placed on your target volume by your Surgeon. This will be the level the Surgeon wants you to raise the piston each time you use the Spirometer.
5. At the end of your inhalation, hold your breath for at least five seconds allowing the piston to fall back to zero.
We recommend that you use your Incentive Spirometer every hour while awake. Inhale ten times each practice session. If it helps you remember, practice using your Incentive Spirometer before each meal and then again right before bedtime. Take your time and slow down if you begin to feel lightheaded.
Your surgeon will prescribe narcotic pain relievers to be used for pain that is not managed adequately with other methods. Fortunately, the great majority of SwiftPath patients do not require extended use of narcotics. Narcotic addiction is a major issue, and diversion of prescription narcotics is a significant related problem. Patients and caregivers should dispose of expired, unwanted or unused medications from their home as quickly as possible to help reduce the chance that others may accidentally take or intentionally misuse the unneeded medicines.
It is advised that patients follow any specific disposal instructions that may be present on the prescription drug labeling or patient information that accompanies the medication.
There are also local take-back programs that allow the public to take unused drugs to a central location for proper disposal. You are encouraged to call your local law enforcement agencies to see if they sponsor medicine take-back programs in your community. There may even be an authorized collector (receptacle) at your local police station and/or City Hall where you may safely dispose of your unused prescriptions. Any unused medications dropped off at specified collecting receptacles will be handled by your local law enforcement and safely incinerated. Patients can visit the DEA’s website (http://www.deadiversion.usdoj.gov/drug_disposal/index.html) to search for local authorized collection sites and view information regarding local take-back events.
If no medicine take-back programs or authorized collectors are available in your area, throw the unused medications in your household trash following these steps:
1. Remove the medication from their original containers and mix them with an undesirable substance (i.e. dirt, kitty litter or used coffee grounds). This will make the medication less appealing to children or pets and will make the medications unrecognizable to anyone intentionally going through trash seeking drugs.
2. Place the mixture in a sealable bag, empty can or other container to prevent the drug from leaking or breaking out of the garbage bag.
3. Throw the container/bag containing your mixture into the household trash
4. Scratch out all personal information on the prescription label of your empty pill bottle or empty medicine packaging to make it unreadable, then dispose of the container as well.
Be aware not to flush medicines down the sink or toilet unless the information present or given with the prescription specifically instructs you to do so. For a list of flushable medications, please go to: http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm#Flush_List