Same-Day Joint Replacement Care: Achieving the Quadruple Aim

SummarySame-day or no-overnight-hospital-stay total hip and knee joint replacements are safe and desirable for patients, but most surgeons performing these procedures do not discharge patients the same day. At Kaiser Permanente, where 20,000 such procedures are performed each year, a physician-led multifaceted expansion strategy empowered surgeons and perioperative teams to change surgical practice on a broad basis. The proportion of patients who safely avoided an overnight hospital stay increased from 7.2% in 2016 to 62.0% in 2019. Patients and surgeons are more satisfied with same-day discharge.