Hip surgery and home the same day

Out­pa­tient joint re­place­ments could re­sult in sav­ings of more than $100M an­nu­ally


At 11:47 a.m., anes­the­sia as­sis­tant An­gela Chan wakes pa­tient Kaori Noguchi. Women's Col­lege Hos­pi­tal is do­ing same-day joint re­place­ment surg­eries. Kaori Noguchi re­calls be­ing taken aback when her sur­geon’s of­fice called to book her hip re­place­ment surgery.

She was told she could have the op­er­a­tion as an out­pa­tient, mean­ing she would be in and out of hos­pi­tal the same day.

Thirty years ago, this pro­ce­dure would have re­quired a hos­pi­tal stay of up to seven days, and more re­cently it’s taken an av­er­age of three days.

“Ini­tially I was a bit freaked out,” Noguchi said, ex­plain­ing that she was con­cerned she would be in too much pain and not mo­bile enough to leave the hos­pi­tal so soon.

But on Mon­day she did just that. The 47-year-old Toronto res­i­dent left Women’s Col­lege Hos­pi­tal just af­ter 4 p.m. — only four hours af­ter be­ing At 4:04 p.m., Noguchi waits for her hus­band to pull the car around to pick her up. At 2:39 p.m., Noguchi works with phys­io­ther­a­pist Hari Nair who will help her learn to stand, sit, walk, and climb stairs be­fore leav­ing the hos­pi­tal.

wheeled out of the op­er­at­ing room and eight hours af­ter ar­riv­ing at the hos­pi­tal.

Women’s Col­lege is the only fully am­bu­la­tory hos­pi­tal in On­tario, mean­ing it has no overnight beds. It de­scribes it­self as “a hos­pi­tal de­signed to keep peo­ple out of hos­pi­tal.”

Part of its mis­sion is to help im­prove the broader health sys­tem. One way it’s try­ing to do that is by spread­ing the word about the ad­van­tages of am­bu­la­tory, or out­pa­tient, surgery.

Sur­geon-in-chief Dr. David Ur­bach said do­ing more join­tre­place­ments this way could take sig­nif­i­cant pres­sure off the en­tire hos­pi­tal sys­tem.

“This ap­proach, ap­plied through­out the prov­ince, has

the po­ten­tial to save a huge amount of money and free up many beds in the On­tario hos­pi­tal sys­tem,” he said.

Ac­cord­ing to data from the hos­pi­tal, ap­prox­i­mately 50,000 hip and knee re­place­ments are done an­nu­ally in On­tario.

The av­er­age hos­pi­tal stay is three days.

If 50 per cent were done on an out­pa­tient ba­sis, that would free up 75,000 days of hos­pi­tal beds an­nu­ally.

That would be the equiv­a­lent of open­ing up a new 200-bed hos­pi­tal.

The sav­ings would amount to more than $100 mil­lion an­nu­ally.

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