11% of Kaiser Hip and Knee Replacement Patients Have No Hospital Stay


A recent Harvard Business Review article explores the approach Kaiser Permanente is taking to speed the healing of their hip replacement patients. After studying their process, Kaiser concluded that half their patients could go home safely the same day of their surgery, if and only if, the entire care team followed a set of carefully coordinated procedures. Many of these procedures would have to take place outside of the hospital setting.

The care team consists of a care coordinator, physical therapist, and a pharmacist who work with the patient before hospital admission. The orthopedic surgeon must perform the surgery from an anterior approach, which significantly reduces the pain of surgery and recovery, and allows the patient to walk immediately. If the patient demonstrates that they can dress and walk safely 30-50 feet after surgery, the care team will discharge them to home.  At home, the patient has six in-home PT sessions, visits by a nurse to check vitals and daily check-ins with the care coordinator. Approximately two weeks later, the patient meets with the surgeon and the care team releases them.

Kaiser reports that 11% of their hip and knee patients have recovered at home with no hospital stay. The benefits of this approach are immeasurable but only work if the care team strictly follows the standards and protocols. So far Kaiser has seen a decrease of hospital-acquired infections, no increase in incidents of readmission, and higher patient satisfaction. Kaiser hopes to have 50 percent of hip and knee patients recover at home by 2018. 

What other procedures do you think fit this approach? Are there other areas you could target to save patients time? Is this something you could successfully implement at your facility? Share your thoughts.