Integrated Systems to Reduce Length of Stay for Knee and Hip Joint Replacement Surgeries

Abstract

To reduce length of stay while maintaining quality of care, St. Joseph's Hospital, Hamilton, ON implemented a care path with three discharge options. Two of these discharge options were early discharge to integrated community services. Patients meeting early discharge criteria are discharged home five days post-operatively with follow-up by home care nursing and physiotherapy. Otherwise, patients are discharged on day four to a multi-disciplinary rehabilitation unit at a separate facility. Patients requiring acute medical services for complications or co-morbidity stay in the acute care hospital. A prospective cohort evaluation showed no difference in complications and similar functional outcomes for the three discharge options.