Abstract
Introduction: Following the successful introduction of a short stay programme for total hip replacements for selected cases in our unit, the effect of utilising an “Outreach Team” for all of our primary joint arthroplasties has been assessed. This team comprises a senior orthopaedic sister and a physiotherapy assistant. Their ethos is to provide continuity of care from the ward into the community, thereby allowing early, supported hospital discharge. We compared length of stay in a case-matched series of patients before and after the introduction of the service. Patient satisfaction was assessed and cost-benefit analysis carried out.
Methods: 200 patients were enrolled on the Outreach Programme following primary joint arthroplasty. Results were compared with 200 case-matched primary arthroplasties prior to the introduction of the team. Discharge was only allowed when patients, carers and staff were happy. Patient satisfaction was assessed via questionnaires.
Results: Following a cost-benefit analysis, we calculate a saving of approximately £235,000 annually, with 936 bed days saved.
99% of patients satisfied with Outreach. There were no readmissions from the Outreach group.
Discussion: The use of an Outreach Team can be used to significantly reduce the length of hospital stay after primary joint arthroplasty. We feel that the use of the same carers on the ward and in the community gives a seamless transition of care, allowing patients to feel secure and confident about their early discharge with high levels of satisfaction. This simple service is highly efficient and cost-effective and we recommend our model to other units.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
