title: Outcomes of a joint replacement surgical home model clinical pathway.
abstract: Optimizing perioperative care to provide maximum benefit at minimum cost may be best achieved using a perioperative clinical pathway (PCP). Using our joint replacement surgical home (JSH) model PCP, we examined length of stay (LOS) following total joint arthroplasty (TJA) to evaluate patient care optimization. We reviewed a spectrum of clinical measurements in 190 consecutive patients who underwent TJA. Patients who had surgery earlier in the week and who were earlier cases of the day had a significantly lower LOS than patients whose cases started both later in the week and later in the day. Patients discharged home had significantly lower LOS than those discharged to a secondary care facility. Patients who received regional versus general anesthesia had a significantly lower LOS. Scheduling patients discharged to home and who will likely receive regional anesthesia for the earliest morning slot and earlier in the week may help decrease overall LOS.
authors.affiliation: Department of Orthopaedic Surgery, UC Irvine Medical Center, Orange, CA 92868, USA.
authors.forename: Avinash
authors.initials: A
authors.lastname: Chaurasia
authors.affiliation: Department of Anesthesia and Perioperative Care, UC Irvine Medical Center, Orange, CA 92868, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Garson
authors.affiliation: Department of Anesthesia and Perioperative Care, UC Irvine Medical Center, Orange, CA 92868, USA.
authors.forename: Zeev L
authors.initials: ZL
authors.lastname: Kain
authors.affiliation: Department of Orthopaedic Surgery, UC Irvine Medical Center, Orange, CA 92868, USA.
authors.forename: Ran
authors.initials: R
authors.lastname: Schwarzkopf
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D019643:Arthroplasty, Replacement / Q000379:methods*; D019091:Critical Pathways; D005260:Female; D006801:Humans; D007596:Joints / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D019990:Perioperative Care