Volume and length of stay in a total joint replacement program

To determine the impact of the new Joint Academy on volume and length of stay (LOS), the authors undertook a retrospective record review for January-March of 2006 and 2007. A total of 413 primary and revision total joint replacements performed by two surgeons were reviewed, with 10.7% more procedures in 2007 than in 2006. The weighted average LOS in 2006 was 3.44 days; in 2007 it was 3.36 days. Significantly, the authors also compared volumes and LOS by weekday of admission and found no statistical variance in average length of stay (ALOS) by weekday of admission. Revisions negatively affected ALOS but added volume. It was concluded that the Joint Academy had a positive impact on volume and LOS, with most patients successfully discharged on postoperative day 3 due to the program's standardized order sets and appropriate resource allocation.