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BioMed Research International
Volume 2014, Article ID 296302, 7 pages
Clinical Study

Outcomes of a Joint Replacement Surgical Home Model Clinical Pathway

1Department of Orthopaedic Surgery, UC Irvine Medical Center, Orange, CA 92868, USA
2Department of Anesthesia and Perioperative Care, UC Irvine Medical Center, Orange, CA 92868, USA

Received 4 February 2014; Revised 1 June 2014; Accepted 2 June 2014; Published 12 June 2014

Academic Editor: Konstantinos Anagnostakos

Copyright © 2014 Avinash Chaurasia et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Optimizing perioperative care to provide maximum benefit at minimum cost may be best achieved using a perioperative clinical pathway (PCP). Using our joint replacement surgical home (JSH) model PCP, we examined length of stay (LOS) following total joint arthroplasty (TJA) to evaluate patient care optimization. We reviewed a spectrum of clinical measurements in 190 consecutive patients who underwent TJA. Patients who had surgery earlier in the week and who were earlier cases of the day had a significantly lower LOS than patients whose cases started both later in the week and later in the day. Patients discharged home had significantly lower LOS than those discharged to a secondary care facility. Patients who received regional versus general anesthesia had a significantly lower LOS. Scheduling patients discharged to home and who will likely receive regional anesthesia for the earliest morning slot and earlier in the week may help decrease overall LOS.