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- Title
Causes of delayed discharge following joint replacement surgery.
- Authors
Williams, Geraint
- Abstract
Aims: After developing an increased awareness of the issues which delay timely discharge, the author conducted a retrospective case note analysis to establish causes and discuss potential solutions for delays at the elective primary arthroplasty unit at Wirral University Teaching Hospital NHS Trust. Methods: A total of 189 patients who underwent total hip or total knee replacements during 2007 were identified. Case notes were scrutinized for causes of failure to achieve target inpatient stay of 5 days or fewer. Findings: Rehabilitation factors were the primary cause of delayed discharge in 66 of the 110 patients who failed to achieve target inpatient stay. Post-operative complications were the second most common reason for extended stay, resulting in 21 delays. Organizational, administrative and occupational therapy factors were the source of the remaining 23 delays. Conclusions: The arthroplasty unit at Wirral University Teaching Hospital NHS Trust provides a comprehensive postoperative rehabilitation service. Factors which affect the speed of rehabilitation are comprehensive and the process by which it takes place cannot be addressed in isolation. Physiotherapy services are functioning at a premium, and further reductions in stay may only be possible by shifting the emphasis away from quality and redefining the functional rehabilitation requirements for safe discharge. Reducing inpatient times in this situation may not be desirable and could compromise the basic principles of what joint replacement aims to achieve.
- Subjects
OCCUPATIONAL therapy; PHYSICAL therapy; JOINT surgery; ARTHROPLASTY; PLASTIC surgery
- Publication
International Journal of Therapy & Rehabilitation, 2010, Vol 17, Issue 1, p34
- ISSN
1741-1645
- Publication type
Article
- DOI
10.12968/ijtr.2010.17.1.45991