Total Joint Surgery Discharge Planning

Do You Know Your Discharge Plan?

• Do you have someone to stay with you for the first few days following discharge? You may need assistance as you move from location to location and settle into a modified routine.
• Do you have transportation home? Remember that trucks, vans, and SUVs are recommended for taller people, as these vehicles are easier to enter and exit while still maintaining hip precautions.
• Can you use a walker in your home?
• If your bedroom is upstairs, can you stay on the first floor for the first couple of weeks, if you need to?
• Sutures will need to be removed seven to 14 days after surgery. Are you planning to have your family doctor remove sutures, or will you come back to Duke?
• Please make arrangements with your local doctor prior to surgery for suture removal.
• If you are not having sutures removed at Duke, your follow-up appointment will be in four to six weeks and will be scheduled for you at the time of discharge.
• Does your prescription plan require pre-authorization for injectable medications? Most patients are discharged with an injectable medication called Lovenox to prevent blood clots, which will be taken for five days after discharge.

After Surgery

Most patients can anticipate a three-night hospital stay. Your doctor, physical and occupational therapists, and patient resource manager will help determine what services you will need at discharge.

If short-term placement is needed and you have a facility preference, please contact them prior to surgery. You can arrange a tour and complete the necessary paperwork for post-op admission. If there are no beds at your chosen facility, other options are available in the Durham area and can be arranged for you.

Putting It All Together

Prior to your surgery, our patient resource manager, Patsy Ward, can assist you with your discharge plans and coordinate the benefits available to you under your insurance coverage. However, you should discuss your anticipated needs with your family or caregivers to help make your discharge a smooth transition. You may call Patsy Ward at 919-681-3730.

Discharge Options

The following discharge options are available:

• You can be discharged home with the required services, such as visiting nurse or physical and occupational therapy personal care aide, if these are deemed medically necessary. The home health services are ideal for those patients who do not live alone. If you need equipment, such as a walker, hospital bed, wheelchair, or bedside commode, these arrangements will be made for you at the hospital.
• If you need more intensive therapies, a short stay at an acute rehabilitation center may be recommended. To qualify for acute rehab, you must be able to tolerate three hours of therapy a day and have a skilled need for two of the following therapies: physical, occupational, or speech. This evaluation will be done during your hospitalization.
• Some patients need to approach therapy at a slower pace and will best be served at a skilled nursing facility (SNF). You have the option of choosing a SNF near your home or staying in the Durham area.