Issue link: https://blog.providence.org/i/1256336
6 Patient Commitment Total Joint Wellness Program Welcome to Sacred Heart Medical Center, Holy Family Hospital- Providence, St. Josephs Joint Wellness program. The goal of our program is to make sure you have the best results from your surgery with us and safely move back into your home from our health care facility. As a participant in our program and to help with your success, we request the following from you: I agree to attend the Total Joint Replacement class as scheduled I agree to identify at least one Care Coach. Someone who is 18 years of age or older who will attend class with me and also be available to assist me at home for at least the first 5-7 days after my discharge. Coach Name: ___________________Phone Number: _____________________________ I agree to follow the instructions for medications, treatments, evaluations and testing before surgery. This may include appointment with other doctors. If I do not understand the instructions, I will call my surgeons office. I agree to verify with my insurance company that I have coverage and understand that coverage as it relates to this surgery and post-surgery care. I understand that if I do well and have no limitations after surgery I may go home the day of surgery or the morning afterward. Following discharge from our facility, home health and therapy may be ordered if medically necessary. I agree to perform physical therapy exercises at home as indicated pre surgery and post-surgery. I agree to have a walker at home prior to my outpatient surgery. I will call my surgeon's office during working hours first for questions related to pain, swelling, redness or concern about infection before utilizing my primary care provider or the emergency / urgent care departments. For life threatening emergencies, shortness of breath, chest pain, sign and symptoms of a stroke I will call 911. By signing below, I am acknowledging I have received and understand this information and expectations of this program I understand failure to act on the above may result in postponement or even cancellation of my surgery, at the discretion of my surgeon and care team, until all conditions have been met. _______________________________ ____________________________________ Patient Signature Date _______________________________ ____________________________________ Care Coach Signature Date If you feel you cannot meet any of these requests, please discuss with your Surgeon.