['Hip-in-a-Day']

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Patient Care Pathways

Background:

• Average hip replacement length of stay in Germany was 10.2 days in 2017.
• Our hospital reduced average stay to 3.8 days over 10 years.
• Development of an ultra-fast-track program for hip arthroplasty.

Purpose of the Study:

• Present the philosophy, treatment principles, and daily routine of the 'Hip-in-a-Day' program.
• Detail the pre-, intra-, and postoperative phases of the ultra-fast-track pathway.
• Discuss challenges within the German healthcare system for short-stay hip arthroplasty.

Main Methods:

• 97 patients (43-77 years) underwent the 'Hip-in-a-Day' pathway from Sep 2015 to Nov 2019.
• All patients received general anesthesia and direct anterior approach (DAA) hip surgery.
• Patients discharged within 24 hours; 30 on surgery day (12h avg), 67 next day (20h avg).

Main Results:

• All 97 patients met discharge criteria within 24 hours.
• 98.9% (96/97) completed the program without readmission.
• 100% patient satisfaction reported with the fast discharge process.

Conclusions:

• 'Hip-in-a-Day' aims for discharge within 24 hours post-surgery.
• Successful implementation relies on interdisciplinary care, anesthesiology, minimally invasive surgery, and patient compliance.
• Ultra-fast-track arthroplasty is feasible, yielding high patient satisfaction; calls for inclusion in DRG system for reimbursement.