Accelerated rehabilitation following total joint replacement (TJR) surgery has become more common in contemporary orthopaedic\npractice. Increased utilization demands improvements in resource allocation with continued improvement in patient outcomes.\nWe describe an accelerated rehab protocol (AR) instituted at a community based hospital. All patients undergoing total knee\narthroplasty (TKA) and total hip arthroplasty (THA) were included. The AR consisted of preoperative patient education,\nstandardization of perioperative pain management, therapy, and next day in-home services consultation following discharge.\nOutcomes of interest include average length of stay (ALOS), discharge disposition, 42-day return to Urgent Care (UC), Emergency\nDepartment (ED), or readmission. A total of 4 surgeons performed TJR procedures on 1,268 patients in the study period (696 TKA,\n572 THA). ALOS was reduced from3.5 days at the start of the observation period to 2.4 days at the end. Discharge to skilled nursing\nreduced from 25%to 14%. A multifaceted and evidence based approach to standardization of care delivery has resulted in improved\npatient outcomes and a reduction in resource utilization. Adoption of an accelerated rehab protocol has proven to be effective as\nwell as safe without increased utilization of UC, ER, or readmissions.
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