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Recommended Citation
Brown J, Levin A, Gonzalez T, et al. Enhancing Same Day Discharge of Primary Joint Arthroplasty through Collaborative Goal Setting and Education. Quality Improvement poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Presentation Notes
Quality Improvement poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Abstract
Background: The Centers for Medicare and Medicaid Services (CMS) removed Total Knee Arthroplasty (TKA) and Total Hip Arthroplasty (THA) from the Inpatient Only List in 2018 and 2020, respectively. Literature indicates that Same Day Discharge (SDD) results in higher patient satisfaction, outcomes and reimbursement compared to inpatient admissions.
Local Problem: In 2019, Davie Medical Center (DMC) achieved Advanced Hip and Knee Certification from the Joint Commission which has sustained to this day. With total joints as a primary service line, DMC aimed to increase its SDD rate from 23.8% in 2023 for ASA I&II patients.
Method: Utilizing Meleis Transition theory, the healthcare team developed a comprehensive, evidence-based educational approach emphasizing patient support through collaborative scripting. Professional Governance teams from ambulatory, surgical services, and recovery units disseminated information. Physicians indicated SDD in their notes, surgical schedules prioritized SDD patients, short-acting blocks and regional anesthesia were used, and physical therapy extended hours to facilitate discharge. The Patient Care Guidelines folder was updated to include SDD requirements and expectations.
Results: The process change involved 2357 patients, resulting in an increase in the SDD rate to 46.6% in 2024. The results support the effectiveness of collaborative scripting across service lines in improving patient satisfaction, safety, and cost-effectiveness.
Implications for Practice: Nurse-led education reiterated throughout the care episode is crucial for advancing a safe practice environment that promotes wellness throughout the patient experience.
Document Type
Poster
Publication Date
11-12-2025
Enhancing Same Day Discharge of Primary Joint Arthroplasty through Collaborative Goal Setting and Education
Background: The Centers for Medicare and Medicaid Services (CMS) removed Total Knee Arthroplasty (TKA) and Total Hip Arthroplasty (THA) from the Inpatient Only List in 2018 and 2020, respectively. Literature indicates that Same Day Discharge (SDD) results in higher patient satisfaction, outcomes and reimbursement compared to inpatient admissions.
Local Problem: In 2019, Davie Medical Center (DMC) achieved Advanced Hip and Knee Certification from the Joint Commission which has sustained to this day. With total joints as a primary service line, DMC aimed to increase its SDD rate from 23.8% in 2023 for ASA I&II patients.
Method: Utilizing Meleis Transition theory, the healthcare team developed a comprehensive, evidence-based educational approach emphasizing patient support through collaborative scripting. Professional Governance teams from ambulatory, surgical services, and recovery units disseminated information. Physicians indicated SDD in their notes, surgical schedules prioritized SDD patients, short-acting blocks and regional anesthesia were used, and physical therapy extended hours to facilitate discharge. The Patient Care Guidelines folder was updated to include SDD requirements and expectations.
Results: The process change involved 2357 patients, resulting in an increase in the SDD rate to 46.6% in 2024. The results support the effectiveness of collaborative scripting across service lines in improving patient satisfaction, safety, and cost-effectiveness.
Implications for Practice: Nurse-led education reiterated throughout the care episode is crucial for advancing a safe practice environment that promotes wellness throughout the patient experience.
Affiliations
Atrium Health WFB Davie Medical Center