St Vincent’s Bringing Care Home strategy is transforming care, allowing patients to spend more time doing the things that matter, rather than extended time in a hospital bed. 

 Following a hip or knee joint replacement, a growing number are spending two nights or less time in hospital.  

It has been proven that many patients report sleeping better at home, have a lower risk of hospital-acquired infections, a faster return to independence and normal routine and more family and carer involvement in their recovery when leaving hospital earlier.  

Less reliance on hospital care for recovery is the “way of the future”, according to orthopaedic surgeon Professor Ross Crawford. 

Prof Crawford, a hip and knee specialists at St Vincent’s Private Hospital Northside, has seen recovery methods changing. 

“My dad and grandad were both surgeons who did joint replacements. Back in their time, in the 1980’s, these patients would spend 10-14 days in hospital, in bed,” Prof Crawford said.

 “We’ve seen procedures and techniques get better and better - patients don’t need to be in hospital. I tell my patients they should be able to go home the next day for a hip and after two days for a knee. Some want inpatient rehab, but I tell them about higher infection rates in hospital and that they won’t get any better outcomes than doing rehab at home.”

Despite this, the average hospital stay after a joint replacement is three or four nights.  

“In Australia, we are way behind the world; in the big US centres and in Europe, most people go home the same day after a joint replacement,” Prof Crawford said. 

At Northside Private, 15 patients stayed two nights or less in both June and April and 10 patients went home after two days or less in May. This saved a total of 100 bed days over a three month period. 

At St Vincent’s Private Hospital Toowoomba, 19 patients stayed two days or less after a joint replacement in June, 16 had shorter stays in May and nine in April , saving about 110 bed days in three months.  

At St Vincent’s Private Hospital East Melbourne, the last three months have seen 27 patients stay two days or less after a joint replacement. 

Prof Crawford says adoption of this new trend is likely to be slow, but necessary. 

“Hip joint replacement is a beautiful operation; it generally provides the patient with excellent pain relief. At home you’ll be getting up to get dressed, you can watch tv on your own couch. You don't need to be in hospital. 

“I wouldn't send a patient home early if it compromised their care. After the surgery, I tell my patients to ring me if there is a problem. That is rare - I get maybe one phone call a year. 

“In the UK, joint replacements patients often don’t even get a ward bed, they are wheeled into recovery and go home from there.” 

Jo Phillips, Nurse Unit Manager on Northside’s orthopaedic ward, says there are multiple benefits for patients recovering at home. 

“One patient experienced delirium after his joint replacement and getting him back home quickly was the best thing for him.  His family was so appreciative that he was back in his own environment, while still being offered physiotherapy at home.” 

St Vincent’s Care at Home – joint replacement program has been adapted from programs run in leading international centres and is available for patients who are medically stable.