Integrated systems to reduce length of stay for knee and hip joint replacement surgeries.
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.
Woo
T
T
St Joseph's Hospital.
Bramwell
M
M
Greenwood
B
B
Gow
S
S
Ackerman-Rainville
R
R
Corradetti
P
P
Wood
S
S
Moreland
J
J
D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation; D015331:Cohort Studies; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006699:Home Care Services; D006764:Hospitals, Community / Q000458:organization & administration; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data* / Q000639:trends; D009864:Ontario; D010360:Patient Transfer; D026761:Physical Therapy Specialty; D012047:Rehabilitation Centers / Q000458:organization & administration