Total Joint Replacement Perioperative Surgical Home Program: 2-Year Follow-Up

Area of Science:

• Healthcare Management
• Surgical Outcomes
• Patient Care Coordination

Background:

• Established one of the nation's first Perioperative Surgical Homes (PSHs) for hip and knee arthroplasty.
• Focusing on extending the PSH model to other surgical services requires evaluating long-term sustainability.

Purpose of the Study:

• To assess the long-term sustainability and impact of the Perioperative Surgical Home (PSH) model.
• To evaluate changes in patient outcomes between the first and second years of PSH implementation for primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Main Methods:

• Prospective data collection from elective primary TKA and THA patients over two years (Oct 2012 - Sep 2014).
• Key metrics included length of stay (LOS), 30-day readmission rates, postoperative pain scores, and complication rates.

Main Results:

• Overall median LOS significantly decreased in the second year of the PSH initiative (P = 0.03).
• Median LOS for THA patients significantly shortened in year two (P = 0.02), but TKA LOS did not differ.
• More patients were discharged home in year two compared to year one (P = 0.02); readmission rates and pain scores showed no significant changes.

Conclusions:

• The second year of PSH implementation showed sustained positive results in LOS and discharge destination.
• The PSH model demonstrates potential for long-term sustainability in coordinating joint arthroplasty care.