Implementation of a day-stay joint replacement pathway in an Australian regional public hospital: A descriptive study.
arthroplasty
orthopaedics
perioperative care
quality improvement
rural
Journal
The Australian journal of rural health
ISSN: 1440-1584
Titre abrégé: Aust J Rural Health
Pays: Australia
ID NLM: 9305903
Informations de publication
Date de publication:
30 Apr 2024
30 Apr 2024
Historique:
revised:
06
04
2024
received:
30
11
2023
accepted:
09
04
2024
medline:
30
4
2024
pubmed:
30
4
2024
entrez:
30
4
2024
Statut:
aheadofprint
Résumé
To describe the implementation, feasibility and safety of a day-stay joint replacement pathway in a regional public hospital in Australia. Over a 12-month pilot period, a prospective descriptive analysis of consecutive patients undergoing total knee and hip arthroplasty was conducted. The number of eligible day-stay patients, proportion of successful same-day discharges and reasons for same-day failure to discharge were recorded. Outcome measures captured for all joint replacements across this period included length of stay (LoS), patient reported outcomes, complications and patient satisfaction. The implementation pathway as well as patient and staff identified success factors derived from interviews were outlined. Forty-one/246 (17%) patients booked for joint replacement surgery were eligible for day-stay and 21/41 (51%) achieved a successful same-day discharge. Unsuccessful same-day discharges were due to time of surgery too late in the day (7/20), no longer meeting same-day discharge criteria (11/20) and declined discharge same-day (2/20). Over the implementation period 65% (162/246) of all patients were discharged with a LoS of 2 days or less. Patient satisfaction for the day-stay pathway was high. Complication rates and patient-reported outcomes were equivalent across LoS groups. The day-stay joint replacement surgery pathway was feasible to implement, safe and acceptable to patients. Day-stay pathways have potential patient and system-level efficiency benefits.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
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