BayCare Leads with Same-Day Discharge for Joint Replacement Patients

June 24, 2024
BayCare Leads with Same-Day Discharge for Joint Replacement Patients

 

At BayCare, transforming patient care can mean spending less time in a hospital bed. Today, one-third of joint replacement patients can go home the day of surgery rather than stay overnight at the hospital, accelerating their recovery.  

“Getting your hip replaced at BayCare is not the same as it was five years ago,” said Emily Scott, BayCare’s chief transformation and service line officer.

For nearly a decade, BayCare has helped patients begin walking as soon as is safely possible following hip or knee replacement surgeries. Five years ago, BayCare’s orthopedic teams began to review studies and rethink overnight hospital stays following joint replacement. “Knowing that we can get patients up and moving the same day led us to develop a protocol to discharge patients for recovery in the home,” said Gina Rowland, director of the orthopedic service line for BayCare.   

Initially, only 1% of BayCare’s joint replacement patients went home the day of surgery, a practice known as same-day discharge. However, as the pandemic unfolded and delayed many surgeries, the urgency for efficient and safe care models became more apparent.

BayCare’s orthopedic teams quickly determined which joint replacement patients might be the best candidates for same-day discharge, always with the option to stay overnight if circumstances changed. At first, these were otherwise healthy, younger patients who had support at home and no barriers like stairs.   

Today, about 33% of BayCare patients spend 10 hours in the hospital from admission to discharge for a knee or hip replacement, and the same-day surgery option is available in all BayCare hospitals. Overall, 99% of total joint replacement patients at BayCare are walking within 24 hours of surgery.  

The orthopedic teams initiating the change worked under the mantle of BayCare’s Care Transformation program, a systemwide, collaborative effort to improve how BayCare delivers health care across 16 hospitals and hundreds of outpatient facilities. One key goal is to reduce unnecessary testing and procedures or hospital stays that don’t contribute to better patient outcomes.   

“Care Transformation is a priority at BayCare because we are constantly pushing the envelope to determine how we can better provide care for our patients,” added Scott. “Same-day discharge is an important initiative because it meets several needs. It streamlines care. It helps patients get home faster and delivers the best quality and outcomes. It helps them jump-start their recovery.”

In a gym, a female fitness instructor with blue leggings on sits on a chair, with one arm stretched out.
With her hip replacement procedure nearly a year behind her, Debra Liberto encourages seniors to remain active and to seek treatment if they are in pain.

 

Debra Liberto, a SilverSneakers fitness instructor who regained her mobility and active lifestyle after her hip replacement surgery at BayCare, opted for same-day discharge and recovery at home. Liberto has taught aerobics and strength training classes for nearly five decades, pursuing her passion for fitness since her high school days. “Health is a gift. Movement is a gift,” she said. “I love encouraging people to stay strong.”  

In 2021, following a car accident, Liberto experienced escalating pain, leading her to treatments like physical therapy and cortisone injections, yet the pain persisted. Finally, after considerable deliberation and sleepless nights, she consulted Dr. Mitch Herrema, chair of the orthopedics department at Morton Plant Hospital. He recommended a hip replacement, which Liberto credits as "the best thing I ever did."  

She didn’t imagine at the time that she could go home the same day she arrived for her surgery, or that she would begin her recovery by walking down a hospital hallway only hours after the procedure.  

Dr. Herrema took part in BayCare’s Care Transformation initiative that prepared BayCare to offer same-day discharge to joint replacement patients.  

“Data showed that an extra day in the hospital was not doing patients any good because they’re not forced to do anything on their own. If they can get up and walk down the hall for therapy or their kitchen or bathroom, they can go home,” Dr. Herrema said. “The patients love it, and the results have been amazing.”  

For Liberto, the recovery was smooth, and she was careful to give herself time to heal. “At my two-week follow-up, I could balance on one foot at a time. I had only used the walker for six days, taking three 10-minute walks daily. I wanted to know when I could begin teaching again. After I walked down the hall and turned around, Dr. Herrema said I could begin to resume teaching the following week.’”  

After three weeks, she returned to teaching SilverSneakers Classic, a 45-60-minute beginner fitness class for seniors. Still, Liberto was selective about what exercises and the types of movements she performed. “There was still a little bit of soreness, but I can do everything now,” Liberto added. “I’m glad I got it done.”  

For more information about joint replacement surgery at BayCare: Joint Replacement Surgery in the Tampa Bay Area