Successful Transition to Same Calendar Day Discharge in Total Joint Arthroplasty at an Academic Center.

Disparities Outpatient Total joint arthroplasty

Journal

Arthroplasty today
ISSN: 2352-3441
Titre abrégé: Arthroplast Today
Pays: United States
ID NLM: 101681808

Informations de publication

Date de publication:
Jun 2024
Historique:
received: 15 08 2023
revised: 07 02 2024
accepted: 14 02 2024
medline: 25 3 2024
pubmed: 25 3 2024
entrez: 25 3 2024
Statut: epublish

Résumé

There has been a shift toward same-day discharge (SDD) in total joint arthroplasty (TJA) in recent years. Our clinical standard had been next-day discharge, but the COVID pandemic led to a hospital bed shortage, causing us to shift to SDD directly from the Post-Anesthesia Care Unit (PACU). The aim of our project was to investigate if the SDD protocol was successful and if it changed complications or 90-day readmission rates. Our secondary aim was to investigate if the protocol created disparities in patient selection. A retrospective review compared the first 100 patients intended to discharge from PACU to the 100 patients prior to the SDD protocol undergoing elective primary TJA procedures at our academic institution from September 1, 2020, to March 23, 2021. The SDD protocol started on November 19, 2020. During this SDD period, 98% (98/100) of patients were successfully discharged from the PACU. The 90-day readmission rate changed from 0% to 2% ( The transition to same SDD in TJA at our academic institution was successfully implemented without markedly increasing complications, readmissions, or changing patient selection. The COVID-19 pandemic likely influenced the recovery of patients before and after the protocol. Future studies are needed to validate this data during the post-COVID era.

Sections du résumé

Background UNASSIGNED
There has been a shift toward same-day discharge (SDD) in total joint arthroplasty (TJA) in recent years. Our clinical standard had been next-day discharge, but the COVID pandemic led to a hospital bed shortage, causing us to shift to SDD directly from the Post-Anesthesia Care Unit (PACU). The aim of our project was to investigate if the SDD protocol was successful and if it changed complications or 90-day readmission rates. Our secondary aim was to investigate if the protocol created disparities in patient selection.
Methods UNASSIGNED
A retrospective review compared the first 100 patients intended to discharge from PACU to the 100 patients prior to the SDD protocol undergoing elective primary TJA procedures at our academic institution from September 1, 2020, to March 23, 2021. The SDD protocol started on November 19, 2020.
Results UNASSIGNED
During this SDD period, 98% (98/100) of patients were successfully discharged from the PACU. The 90-day readmission rate changed from 0% to 2% (
Conclusions UNASSIGNED
The transition to same SDD in TJA at our academic institution was successfully implemented without markedly increasing complications, readmissions, or changing patient selection. The COVID-19 pandemic likely influenced the recovery of patients before and after the protocol. Future studies are needed to validate this data during the post-COVID era.

Identifiants

pubmed: 38524150
doi: 10.1016/j.artd.2024.101354
pii: S2352-3441(24)00039-6
pmc: PMC10958211
doi:

Types de publication

Journal Article

Langues

eng

Pagination

101354

Informations de copyright

© 2024 The Authors.

Auteurs

Candler G Mathews (CG)

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Jeffrey B Stambough (JB)

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Benjamin Stronach (B)

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Eric R Siegel (ER)

Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

C Lowry Barnes (CL)

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Simon C Mears (SC)

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Classifications MeSH