A designated three day elective orthopaedic surgery unit: First year’s results for hip and knee replacement patients

SummaryBackground: A short stay elective centre was opened in 2007 at The Alfred in Melbourne, Australia. The objective was to safely discharge patients home on the third post-operative day. This prospective observational study reports the outcomes for hip and knee replacement patients during the first year of operation. Methods: Forty-seven patients (28 women and 19 men; mean age 65 years) were eligible for the study. Data was collected at preadmission, discharge and 6 months. Results: Thirty-four of 47 patients (72.3%) achieved discharge home within 3 days. Mean length of stay for the whole group was 4.55 days (95% CI 3.78–5.33 days). Patients who had medical complications were significantly more likely to stay longer than 3 days (p < 0.001). Patients with more pre-operative co-morbidity were more likely to suffer a post-operative medical complication resulting in a stay longer than 3 days (p = 0.09). Six month re-admission rates were 6% for those with a 3 day discharge and 15% for others. Conclusions: Preliminary findings suggest that a 3-day length of stay is possible for a defined group of patients, and can be achieved without increase in complication or re-admission rates. Failure to achieve Day 3 discharge is primarily related to medical complications.