ing the option of a same-day program a virtual necessity. We knew
back when we started thinking about same-day discharge that
Medicare would eventually remove total joints from the inpatient-only
list, and we wanted to be ahead of the curve when they did.
Plus, there are the metrics. Research shows that when hip and knee
patients are discharged same-day, they tend to be more satisfied, and
less prone to infection and readmission.
All in all, a successful same-day joints program offers an opportunity to
both give patients better surgical outcomes and post-op recoveries. Since
rolling out our same-day total joints program in 2015, we've achieved a
94% same-day discharge success rate for procedures that normally
require a 2-to-3 night stay (total hips) or a 3-to-4 night stay (total knees).
Plus, only 1% of our same-day patients are readmitted, and they outper-
form non-same-day patients in each of the 11 Hospital Consumer
Assessment of Healthcare Providers and Systems (HCAHPS) bench-
marks.
If you're considering implementing a same-day joints program at
your facility, here's what you should know.
Get the key players involved early
We can't overstate the role your physician-champion plays in the
process, but you need to get buy-in from all of your key players right
from the get-go. We knew early on that the success of our same-day
joints program, pardon the pun, hinged on a lot of different disciplines
working together as seamlessly as possible. On top of our surgeons,
nurses and anesthesiologists, pre-admission testing and acute services
departments played a critical part for us. We mapped out everything
everyone does — day in and day out and in as much detail as possible
— to ensure staff understood the processes, workflow and protocols
for each and every patient we identified as a same-day discharge.
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