Patient and provider experience with a new model of care for primary hip and knee arthroplasties.

Background: The orthopaedic program at a large academic teaching hospital introduced a quality initiative for the primary hip and knee arthroplasty population with the goal to reduce the overall length of stay (LOS) to less than 3 days while ensuring an efficient and exceptional patient experience. This article focuses on the process used to evaluate patient and provider satisfaction with the changes made to achieve a reduction in length of stay.

Method: The initiative involved current and future process mapping, patient and staff education, a comprehensive mobility strategy, pain management pathways and an evaluation of the patient and provider experience.

Practice change: the process of developing and implementing a nursing care delivery model for geriatric rehabilitation.

The authors describe a participative management approach was used to develop and implement a nursing care delivery model for geriatric rehabilitation. This approach led to a sense of shared decision making and established consensus among the majority of staff. An integrated primary and modular nursing model that incorporated a geriatric resource nurse role was developed to maximize accountability and continuity of care.