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Nationwide, there is a trend in orthopedic surgery to move total joint arthroplasty, commonly known as joint replacement, from inpatient to outpatient surgery. Patients benefit from the shorter hospital stay, and they are more satisfied recovering in the comfort of their own home.
At Mayo Clinic, physicians from orthopedics and anesthesiology have been working together on this initiative as part of the OASIS project. Oasis stands for Orthopedic Surgery and Anesthesiology Surgical Improvements.
"This is a team approach to practice optimization," explains Dr. Hugh M. Smith, a Mayo Clinic anesthesiologist. "One of our first targets was to try to bring down that length of stay."
A decade ago, a patient who had a knee replacement or hip replacement would likely stay in the hospital for a week, says Dr. Smith. Even four years ago, the average hospital stay was around four days. Now some patients are able to go home the same day.
"It's a patient satisfier," says Dr. Matthew Abdel, a Mayo Clinic orthopedic surgeon. "You recuperate with your family. You recuperate in your own home environment. You don't feel like you're institutionalized. You feel like you're a part of a well model of care, not a sick model."
To practice safe social distancing during the COVID-19 pandemic, this interview was conducted using video conferencing. The sound and video quality are representative of the technology used. For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where social distancing and other safety protocols were followed.
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An important fact to consider is whether the home is equipped and capsble of having the patient home right after or one day later. In my case, my broken hip was accidental and replaced in a hospital. My spouse, alone, could not have possibly given me the cate needed on such notice. Because of that I was transferred to a rehab hospjtal for care and physical therapy . I then had confidence in coming home to great home care.
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4 ReactionsI stayed two nights for hip replacement 5 years ago & 3 nights for the other hip 10 years ago. I went home same day after my total knee replacement this last November. I had my surgery at Marshfield Medical Center in WI. I am glad I didn’t have to stay over night this time. There are two steps from our garage into the kitchen. With my walker and my husband standing by, I was able to get up the steps just fine. My block hadn’t totally worn off so it wasn’t painful to ride home in the car or to go up the steps. The next day it wore off & I would have been more miserable riding home. I appreciated being home same day in my own chair and my own bed. I will do it as an outpatient again when I have my other knee replaced.
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3 ReactionsI agree, it helps to have the time to get the house set up for post op needs. You weren’t able to do that since your broken hip was unexpected. In that case you were most likely better off with some temporary in patient care.
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2 ReactionsI had 2 knee replacements and I could never have gone home the same day for each of them. The pain was intense, and living alone would have been a traded to let me leave. I think each case should be reviewed on its merit.
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2 ReactionsIf you do not have someone at home to care for you, you have to go to what is laughingly called a skilled nursing facility. Almost as one, all of us who have been there call it hell. They are understaffed and it is a miracle that one survives.
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2 ReactionsTwo TKR's - first one was in hospital for 4 days. Second one had nerve block and released next day. Even though I knew I had to climb steps at home. I was so happy to be there!
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2 Reactions5 years ago had one total knee replaced on a Tuesday, to rehab on
Friday since I lived alone and had stairs. One week later, dicharged to home with outside PT and driving car two weeks later to continue PT. The stay at rehab was not 100 per cent but thankful there was someone to treat my pain at 3am and the therapy staff supportive and encouraging. Pat K
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1 ReactionThis criteria only works if you have a home to go to and a loved one to care for you. There is no skilled nursing facility that is known as anything but hell. You just stay there 3-4 weeks before you can get back to your home. If you are lucky you will find a caregiver. If not, you are on your own. Takes much longer to recover.