How efficient is patient discharge following lower limb arthroplasty?

Perioper Med (Lond). 2015 Apr 30:4:5. doi: 10.1186/s13741-015-0015-y. eCollection 2015.

Abstract

Background: Appropriately timed patient discharge is essential for optimal patient care and efficient hospital functioning. The post-operative morbidity survey (POMS) is the only validated prospective method of measuring short-term post-operative morbidity. It has not previously been used as a bed utilisation tool.

Methods: We collected POMS data from 529 consecutive lower-limb arthroplasty patients over a 1-year period and recorded the number of patients remaining in the hospital without morbidity, together with alternative reasons for remaining in hospital. Data was collected on post-operative days (POD) 3, 5, 8 and 15.

Results: On POD 3, 45% of hip arthroplasty patients and 52% of knee arthroplasty patients remained in hospital with no identifiable morbidity. On POD 5, 53% of hip arthroplasty patients and 47% of knee arthroplasty patients remained in hospital with no identifiable morbidity. These figures declined by POD 8 and 15. The most common reason for inappropriate bed occupancy was ongoing physiotherapy and occupational therapy.

Conclusions: We believe POMS is able to identify patients remaining in hospital with no significant morbidity and has utility as a prospective bed utilisation tool. Addition of a mobility measure to POMS may improve its utility in detecting morbidity requiring hospitalisation, particularly following lower limb arthroplasty.

Keywords: Arthroplasty; Bed utilisation; Post-operative morbidity.