Page 14 - Christiana Care Focus January 2018

EVENTS
NASA | CONTINUED
What stands out to you about your visit to Christiana Care?
TR: One of the more interesting things that stood out
to me was the interdisciplinary nature of Christiana’s Strong Bones and Safe Steps programs. In much the same way NASA tackles musculoskeletal health in our astronauts, Christiana Care’s approach to prevention uses a range of different experts to evaluate a particular individual’s needs. The overlaps between the programs have opened up some interesting discussions of potential opportunities for collaboration in areas that could benefit both NASA and Christiana Care.
Dr. Galinat, where do you see a connection between NASA’s research and what Christiana Care is doing?
BG: The connection is to reach for a better future, to use research and discover knowledge that keeps people healthy and active.
Bone health is the cornerstone of our Musculoskeletal Service Line. Our Strong Bones effort has helped more people gain an understanding of their bone health and how to receive proper treatment. For instance, there is a quick evaluation called a Bone Density Test that helps identify people at risk for bone fracture. Unfortunately, sometimes we learn about poor bone health after a fracture. But there are still opportunities for our bone health program to help a patient heal a fracture and prevent the next one. To prevent fractures there are innovative programs at Christiana Care, such as the Safe Steps and Strong Bones programs.
Using a multidisciplinary approach, the Safe Steps and Strong Bones programs coordinate care with primary care physicians. For instance, Safe Steps involves an evaluation by physicians, physical therapists and a nurse navigator. A first goal is to educate people on how they can decrease their risk of falling and might include ridding the kitchen of throw rugs, which can trigger a fall. While we do excellent work fixing things, we would rather bones not get broken. With Strong Bones, a patient can be referred pre-operatively or after a surgical repair. Prior to surgery, it’s important for patients to understand their Vitamin D level, their bone density and their calcium intake for a better outcome.
Our model is much like that of the Helen F. Graham Cancer Center & Research Institute, where different specialists come together so a patient doesn’t need separate visits. We know primary care physicians
address many needs, and bone health can fall down the list of what is discussed. And that’s why this is a silent disease. So, with our Strong Bones program,
we go beyond the primary care physician so patients can talk with a geriatrician, a rheumatologist, as well as specialists in physical medicine and rehabilitation. Better communication leads to better-coordinated care and better health.
What advice do you have for people who want to practice optimal bone health?
BG: News flash — there is no news. It’s what Dr. Ruttley suggested: better diet and exercise. People can help themselves through weight-bearing exercise, proper dietary calcium and Vitamin D, if a supplement is needed. That takes care of the vast majority of people. Beyond those basics, we hope the research being done on the International Space Station will give us more options to help people who need additional treatments.
Where is the leading edge of interest in the practice of orthopaedic medicine?
BG: Christiana Care is leading the region in surgical pain management techniques that allow for the limited use of opioids after surgery. In some cases no opioids are used. Now imagine a joint replacement procedure and taking no narcotics. We have been able to do that with some patients.
Tell us about the Center for Advanced Joint Replacement. What makes that unique?
BG: Our comprehensive program is nationally recognized, and the special sauce is our partnership with community surgeons. Each year, we do about 3,000 spine surgeries and 3,000 hip- and knee- replacement surgeries. We have collaborated with the hospital’s Department of Quality and Patient Safety
to decrease the length of stay of joint patients, and decrease the percentage of patients going to skilled nursing facilities. We not only focus on quality, but we also focus on making care affordable by delivering surgeries at lower costs. We have decreased the internal costs associated with joint replacement surgery by 17 percent in last two years. Now we have an opportunity to forge a new partnership with NASA that will help us even further improve orthopaedic care for our neighbors throughout Delaware and its surrounding areas. ●
14 • FOCUS JANUARY 2018