“High Performing” Orthopedics Led by Bucks County Orthopedic Specialists is a key contributor to the recent rankings.
Doylestown Hospital was recently ranked as one of the best hospitals in Pennsylvania by U.S. News & World Report, and Bucks County Orthopedic Specialists (BCOS) is particularly proud of the accolades earned in orthopedics. Ranked 6th in the Philadelphia metro area, and 12th in the state of Pennsylvania, the hospital earned “High Performing” status in several areas including hip fracture, hip replacement surgery and knee replacement surgery, contributing to its strong overall ranking. In fact, “High Performing” is the top designation for a procedure as rated by the annual U.S. News & World Report Best Hospital Honor Roll.
In recognizing the hospital’s outstanding orthopedic unit, these rankings also honor the BCOS team, including our own, Charles Burrows M.D., who is in his second term as the Medical Director of the Orthopedic Service Line at Doylestown Hospital. We recently sat down with Dr. Burrows to discuss the U.S. News & World Report award, how BCOS and Doylestown Hospital stay at the forefront of innovation, and how same-day joint replacement surgery is a timely evolution in patient care.
Read on for Dr. Burrows’ experiences and insights.
What are your thoughts on the U.S. News and World Report rankings and specifically, how orthopedics’ “High Performing” status was a contributing factor?
I am extremely proud of these rankings and the recognition it means for the dedicated professionals who make up the best orthopedic team at Doylestown Hospital. The rankings are based on many factors that contribute to excellent patient outcomes and patient safety. And none of us can provide that alone. We have an exceptional team of professionals in orthopedics. Our physicians, physician assistants, nurses, physical therapists, and the administration are all vested in providing exceptional outcomes and making sure that people in our community are well taken care of.
It’s gratifying to receive the formal recognition for our program. I’ve been fortunate enough to provide orthopedic care to many hospital employees, including employees of other hospitals, who have sought care at our institution. That says volumes about the type of care we’re delivering here and that can only be done when a team of people all share a single vision of excellence in providing the best orthopedic patient care.
Knee replacement and hip replacement surgeries both received excellent ratings in the report. Can you explain how the joint replacement program has evolved at BCOS and Doylestown Hospital?
Total joint replacement surgery has changed dramatically in the 22 years since I was fellowship trained as a replacement specialist. Historically, joint replacement patients stayed in the hospital for many days. One of the first major improvements we developed was a rapid recovery program that reduced the hospital stay from a week to a few days and then was reduced even further to just an overnight stay. Now my BCOS colleagues and I can offer same-day joint replacement surgery where patients go home a few hours after surgery. This newest program has been extremely successful for our patients.
And while we consider ourselves pioneers in the development of outpatient joint replacement surgery, we certainly didn’t get there overnight. It has been a methodical, thoughtful progression. We were meticulous in examining protocols, procedures, and outcomes with our anesthesia colleagues, nurses, physical therapists, and the hospital administration. The same-day joint replacement surgery program is successful not only due to ingenuity and innovation, but also because we took the time to collaborate, to map out every detail, and to carefully test every protocol before expanding more broadly.
The fact that a patient can arrive at the hospital in the morning, undergo hip replacement or knee replacement surgery, and then be home by that afternoon is not only amazing, but also a testament to teamwork and dedication at every level.
My BCOS colleagues and I are proud to help lead this innovation in the state of Pennsylvania and have worked to expand the program for more patients. We are also the only practice currently performing these procedures at Doylestown Hospital.
Do you believe that the BCOS same-day joint replacement surgery program contributed to the high rankings from U.S. News & World Report?
Yes. I think when you’re pushing the envelope on care pathways, it makes you look much deeper into what you’re doing. As we’ve gone through these evolutions, we really investigated what was working and what could be improved. We got very good at trying protocols and picking and choosing things that helped patients get better faster.
Of course, you don’t want to push the envelope just for the sake of pushing it. But we found that when we could get patients up and moving quicker, they had far less complications and far more comfort. We could see that as we accelerated rehab, patients had much better outcomes and satisfaction scores.
How many outpatient joint replacement surgeries have been performed to date?
To date, we have performed over 1000 of these surgeries.
What advancements have made it possible to do a total joint replacement as an outpatient procedure?
A big shift has been in anesthetic care. Partnering with our anesthesia colleagues has been really important. Our same-day surgeries are done with sedation and a short-acting spinal or regional anesthetic, in lieu of general anesthesia, eliminating the vast majority of side effects associated with general anesthesia.
Post-surgical pain management has been another evolution, which has allowed us to get patients home, comfortably, the day of their surgery. Local nerve blocks, and medications such as Tylenol and anti-inflammatories reduce pain and allow us to decrease the use of narcotic medication.
To what do you attribute the overall quality and success of orthopedics at Doylestown Hospital?
I think a lot of it has to do with the people who are working there. For example, our BCOS surgeons who are doing joint replacements have trained at institutions such as Harvard, Stanford, and the University of Pennsylvania. So, we have extremely well-trained doctors who are delivering care in our community. I think it starts with them.
Of course, our support staff is also excellent. Cheryl Talamo PT, MPT has been a hands-on Director of the Orthopedic Institute, and is always looking for ways to improve care and the patient experience. We also have an orthopedic navigator, Pam DiPietro, who is the individual guiding patients from the time before they have surgery, to when they’re in the hospital, to when they’re discharged to home. She is excellent at coordinating care and patients really appreciate her guidance.
We also have an excellent nursing team and an administration that supports orthopedics, urges us to innovate, and provides us with exceptional facilities to provide excellent care. And finally, our new Ambulatory Center right next to the hospital has helped the program because it provides a brand-new, state-of-the-art outpatient site for follow-up appointments and physical therapy. It really centralizes our orthopedic efforts and streamlines recovery and rehab for our patients.
What advancements in orthopedics do you see on the horizon?
I think you’re going to see more and more people electing for outpatient surgery and more rapid recovery from procedures, especially for hip, knee, and shoulder replacements. The COVID-19 pandemic has only accelerated this process.
You’re also going to continue seeing highly durable, well-designed surgical implants that help patients go from a painful, difficult existence, to a pain-free existence.
You’ve held a leadership role in orthopedics at Doylestown Hospital for over a decade and are currently in your second two-year term as Director of the Medical Line for Orthopedics. Why do you feel it’s important to be involved as a leader, rather than only as a practitioner?
I believe that if you don’t take the time to put in the administrative hours, the program becomes stagnant, new things are not embraced, and it’s harder to make change. It’s extremely important for keeping a program vibrant and allowing us to be viewed as one of the best orthopedic programs in this huge Philadelphia market and to earn this top ranking.
