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Archive February 2018 XIX, No. 2

3 Tips for Total Hip Efficiency

Keys to success with same-day hip replacements.

Christopher McClellan, DO


Hip Tools
IN AND OUT Total hip surgeries can take only 45 minutes and your patient can be out of the facility within hours when you take steps to boost efficiency.

The thought of outpatient total hip replacement would have been unbelievable just a few years ago, when the surgery lasted 2 to 3 hours and the post-op hospital stay was measured in days, not hours. But today we routinely discharge patients 3 hours after their surgery so that they're home in time for dinner.

The well-choreographed day of surgery looks like this. The patient meets for about an hour in the morning with a nurse to review the surgery, medications and home care. The surgery takes about 45 minutes, then there's recovery and a 40-minute walking-light therapy session. Many facilities arrange for a patient to spend the first post-op night or two in a nearby hotel, but we let the patient recover at home, where nurses and physical therapists will visit. How do we make this happen? Here are 3 keys to success with same-day hips.

1 Follow a set day-of-surgery routine

At our facility, we conduct up to 4 to 6 total joint surgeries at a time, but we generally have several other procedures scheduled as well, so it becomes crucial to have a set plan that surgeons, nurses and administrators are clear on, and ready to carry out.

A day of surgery starts with a patient arriving 90 minutes before his scheduled start time. We schedule all of our total hip and knee procedures for the morning. Our doors close at 5 p.m. and we want to give patients adequate time to recover following the surgery before they have to go home.

Our patients have already met with many of the team members — including the surgeon, anesthesia provider, a nurse and home therapy helpers — in earlier consultations, so they're comfortable with the staff members and more at-ease the morning of surgery.

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