title: Improving surgical access: the Vancouver experience.
abstract: The University of British Columbia Hospital program was designed to augment existing provincial capacity for hip and knee replacement. The patient-surgeon relationship was maintained throughout the entire care pathway and "ring-fenced" capacity (i.e., designated hospital ward bed and operating room capacity that is geographically remote from the emergency intake of patients) minimized the risk of cancellations. Analysis of the results revealed a mean patient satisfaction score of 4.7 out of 5, a complication rate of 4.4%, a mean operating room time of 1 hour and 45 minutes and a mean postoperative length of stay in hospital of 3.4 days. More than 1600 joint replacements -- an additional 16% provincial capacity -- were performed within budget during each of the first 2 years of operation. A high standard of care was maintained, with high rates of patient satisfaction and a low complication rate.
authors.affiliation: Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Williams
authors.forename: Carolyn
authors.initials: C
authors.lastname: Iker
authors.forename: Laurie
authors.initials: L
authors.lastname: Leith
authors.forename: Bassam A
authors.initials: BA
authors.lastname: Masri
mesh_terms: D019643:Arthroplasty, Replacement; D001955:British Columbia; D015331:Cohort Studies; D019091:Critical Pathways / Q000458:organization & administration; D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D017060:Patient Satisfaction; D018579:Patient Selection; D010817:Physician-Patient Relations; D059039:Standard of Care; D014850:Waiting Lists