Predicting Discharge Disposition and Length of Stay Following Total Hip and Knee Arthroplasty 

Total joint arthroplasty (TJA) is a commonly performed procedure, with ~1000 cases per year completed at St. Michael’s Hospital. Over the past 10-15 years, post-operative management of these patients has changed considerably, with the average hospital length of stay (LOS) decreasing from 5 days to the current average of 2.5 days. An ongoing challenge for the interdisciplinary team that manages TJA patients is accurately predicting which patients will meet the targeted LOS, and which patients will require a longer stay in hospital and who will need inpatient rehabilitation.

Accurately predicting LOS and discharge disposition would allow clinicians to better allocate scarce resources (physiotherapy, discharge planning, etc.), and flag patients who may require intervention to potentially improve their LOS or avoid discharges to inpatient rehabilitation.

Representatives of the interdisciplinary team managing TJA patients reached out to LKS-CHART to develop an accurate algorithm that predicts LOS and discharge disposition following TJA at SMH. This algorithm would be utilized during the consent process at the patient’s initial appointment, and would jointly inform both the patient and interdisciplinary team of the proposed clinical pathway.

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