Orthopedic Services Quality Report SERVICES

Patient Care and Safety Joint Replacement Our goal is to help patients return to home as quickly as The skilled and experienced surgeons on our medical staff possible while ensuring their safety and success. These perform progressive joint replacement procedures for the knee, measures include: hip, shoulder and elbow. The number of joint replacements conducted at Maury Regional Medical Center has continued to • Joint Replacement Class: Maury Regional Medical Center increase for the past three years and more than 900 joint offers joint replacement classes prior to surgery to educate replacements were conducted in fiscal year 2015. Physicians patients regarding the procedure, pre-surgery exercise, evaluate patients to determine what procedure and device best infection control precautions, physical therapy, discharge meet the patient’s individual needs. Among the options planning and much more. Patients will also learn from available are: individuals who have already had joint replacement surgery. • Total hip replacement • Mobility: Members of the nursing staff, many of whom have • Total hip with anterior approach additional certification in orthopedics, quickly begin • Total knee replacement ambulating patients while taking measures to reduce the • Partial knee replacement likelihood of falls post-surgery. The physical therapy staff will • Gender-specific knee replacement ambulate the patient the day of surgery and progress to a • Total shoulder replacement designated walking goal individualized to the patient by the • Reverse total shoulder replacement date of discharge. • Elbow replacement Our goal is for the patient to be discharged home following surgery. Rehabilitation options may include outpatient physical therapy or home health visits. The post-hospital care plan is Spine Procedures based on the individual needs of each patient and is determined by the patient and physician. Surgeons on the medical staff have extensive experience repairing lumbar, thoracic and cervical damage and/or conditions of the spine. Procedures performed include: • Artificial disc replacement • Cervical foraminotomy • Discectomy and microdiscectomy • Fusion (anterior, posterior and lateral) • Kyphoplasty • Laminectomy • Laminoplasty • Osteotomies and deformity re-alignment

Minimally Invasive Repairs In addition to expertise in joint replacements and spinal surgeries, the surgeons on the medical staff also perform minimally invasive procedures to repair: • Cartilage • Rotator Cuff • Ligaments • Tendons • Carpal Tunnel ACHIEVING RESULTS

Maury Regional Medical Center performance is better than the national average and national best practice hospitals.

COMPLICATIONS Maury Regional Medical Center has 10 received numerous recognitions for its commitment to outstanding care and DESIRED OUTCOME 8.09 outcomes for orthopedic patients. Our 7.78 clinical quality measures have been 8 compared to medical centers across the nation and we have excelled. 6.23 5.69 5.76

Recognitions include: 6 4.86 4.10 Percent 4 3.57

2.54 2.29 2 1.75 1.09

0 National Average National Best Practice MRMC National Average National Best Practice MRMC National Average National Best Practice MRMC National Average National Best Practice MRMC Total Hip Total Knee Total Shoulder All Orthopedic • CareChex® rated Maury Regional Replacement Replacement Replacement Procedures Medical Center for 2016: #1 hospital in the market and top 10% in the nation for Medical LENGTH OF STAY Excellence in Joint Replacement 5 #1 in Tennessee and top 100 hospitals in the country for DESIRED OUTCOME Medical Excellence in Orthopedic Care 4 • Excellence Award from the Tennessee Center for Performance 2.93 3 Excellence 2.70 2.63 2.56 2.44 2.32 2.33 • The Joint Commission Certification 2.18 for Hip and Knee Replacement Days 2.05 2 1.66 • BlueCross BlueShield Blue 1.51 Distinction Center Designation 1.24 These accolades are the result of the 1 evaluation of federally reported clinical data. This document further outlines our services and our 0 National Average National Best Practice MRMC National Average National Best Practice MRMC National Average National Best Practice MRMC National Average National Best Practice MRMC accomplishments in quality care. Total Hip Total Knee Total Shoulder All Orthopedic Replacement Replacement Replacement Procedures

The number of patients being discharged to home has increased nearly 14% from 2013 until 2015. ORTHOPEDIC PRACTICE LOCATIONS

Columbia Orthopedic Clinic 1300 Trotwood Avenue Columbia, TN 38401 931.388.3104 Mid-Tennessee Bone and Joint Clinic 1050 N. James Campbell Boulevard, Suite 200 Columbia, TN 38401 mtbj.net ORTHOPEDIC SURGERY 931.381.2663 Mid-Tennessee Bone and Joint also offers convenient clinic locations in PHYSICIANS Hohenwald, Lewisburg and Pulaski.

OUTPATIENT PHYSICAL THERAPY Jeffrey T. Adams, M.D. Maury Regional Medical Center offers patients comprehensive rehabilitation services at facilities throughout our region. Our large staff Randall L. Davidson Jr., M.D. consists of physical therapists, occupational therapists, speech and Alton Lee Hunter Jr., M.D. language pathologists and athletic trainers. Staff members have added credentials in pediatric neurodevelopmental therapy, hand therapy, Scott W. McCall, M.D. lymphedema management, ergonomic assessment and functional Jonathan R. Pettit, M.D. movement. Our staff utilizes therapy equipment, including two anti-gravity treadmills, to assist orthopedic patients on the road to Erion Qamirani, M.D. recovery. W. Cason Shirley, M.D. J. Fredrick Wade, M.D. Locations H. James Wiesman Jr., M.D. Maury Regional Maury Regional Spring Hill Physical Therapy Center Physical Therapy C. Douglas Wilburn, M.D. 858 W. James Campbell Boulevard 1003 Reserve Boulevard Columbia, TN 38401 Suite 310 931.380.4014 Spring Hill, TN 37174 F 931.380.4107 931.486.1544 Chapel Hill Physical Therapy F 931.489.2629 4700 Nashville Highway Marshall Medical Center Chapel Hill, TN 37034 Physical Therapy 931.364.3400 Medical Office Building F 931.364.3401 Suite 205 Lewis Health Center 1090 N. Ellington Parkway 621 W. Main Street Lewisburg, TN 37091 Hohenwald, TN 38462 931.270.3676 931.796.6216 F 931.270.3628 F 931.796.6211 Wayne Medical Center Maury Regional Physical Therapy Physical Therapy Pulaski 308 Highway 64 East 425 W. College Street Waynesboro, TN 38485 Pulaski, TN 38478 931.722.2063 931.424.9300 F 931.722.2040 F 931.424.0833

HOME HEALTH

1224 Trotwood Avenue Maury Regional Home Services has been recognized as one of the Columbia, Tennessee 38401 top-performing home health agencies in the United States by 931.490.7105 HomeCare EliteTM for ten consecutive years. This ranking is based on an mauryregional.com/orthopedics.htm analysis of quality outcomes, quality improvement and financial performance. Patients develop a one-on-one relationship with highly qualified staff who provide them with individualized care that may include nursing services, physical therapy and more. The Maury Regional Home Services team monitors patient progress closely and provides reports to physicians. Services are available in Maury, Marshall, Lawrence, Williamson, Lewis, Giles, Wayne and Hickman counties. 3/16