Best Practices: Total Joint Surgery in an ASC

Outpatient total joint replacements are becoming more and more attractive to patients. Particularly in a post-COVID-19 world, patients are attracted to the idea of at-home recovery and a shorter length-of-stay in the acute setting. As demand rises, outpatient joint replacements are expected to increase by nearly 80% over the next few years. Your ASC can meet this increasing demand by optimizing and implementing best practices now for total joint surgery. 

Proper patient selection

When your institution decides to offer total joint replacements, evaluating your patient population is crucial. General health status, socioeconomic status, and comorbidities are all essential factors to assess. While there is no strict risk stratification system to follow, ASCs must account for the patient’s overall comorbidities, as well as how those comorbidities are being managed. In general, patients must be healthy and reasonably active to ensure a lower risk of complications and thus be good candidates for outpatient total joint replacements. 

Robust patient education 

Optimizing patient outcomes hinges on proper patient and family education. Does your patient have an identified support person who will help them during recovery? Having a family member or other person who can provide supportive care during the recovery period is another factor that will affect patient outcomes. 

When offering education to your patients, you must account for all types of patients. One conversation in the pre-op setting is not enough. In addition to handouts, verbal communication, and follow-up phone calls, a robust digital strategy can significantly enhance your patient education efforts. With some platforms, you can personalize and automate educational information based on the patient’s medical record. To ensure the maximum benefit to patients, use a variety of mediums, including email, texts, and videos containing educational material. 

Maximizing safety, efficiency, and outcomes 

Another critical element of an outpatient joint replacement program is to have fully qualified staff experienced in these procedures. Your anesthesia, surgery, and recovery room teams all must be trained and experienced in the modalities that optimize patient outcomes, such as early mobilization and adequate perioperative pain control. Additionally, your program should include a physical therapist or another staff member who is adequately trained to determine a patient’s safety to return home. 

Post-discharge, proper follow-up with patients is crucial for optimal outcomes. This includes a streamlined hand-off to a physical therapist, a post-op phone call, as well as robust and strategically-timed educational material. As you work to put these best practices in place, not only will you maximize safety and efficiency, but patient satisfaction and outcomes will also improve. 

Interested in this topic? We have a FREE webinar on October 14th called "How 1MP Can Improve Your Total Joint Program." Click here to register!