The driving philosophy upon which the discharge planning process is built is that the the BEST place for patients to be is in their own HOME. So we strive to get you there as soon as is appropriate for each individual. Acheivement of good outcomes and function is a partnership of effort. Your role is to actively participate through exercise and daily activity.

The following are the criteria used to assess the appropriateness of a discharge destination after the hospital. We must also follow the requirements of the payer/insurance companies. Occasionally that changes the services available to an individual patient and we must make adjustments in their plans.

Home discharge is for patients that are:

• Primary Hip replacement
• Medically Healthy
• Able to walk prior to surgery
• Achieve critical path goals
• Have in home support from family/friend

Skilled care (SNF) discharge is for patients that are:

• Not able to walk prior to surgery
• Frail and/or advanced age
• Have complications during recovery
• Do not meet critical path goals
• Have no in home support

We at Illinois Bone and Joint Institute meet with patients individually in the pre-op class. We assess each person's needs and resources and make a personalized plan. Knowing ahead of time can help with planning and readiness.

Once your plan has been identified, you can use the time between the class and your surgery to secure equipment, inform your family and, if appropriate for you, and/or visit a skilled facility and make your reservation.

Discharge plans are revisited after your surgery in the hospital by the social worker. This is an opportunity to consider anything that may have occurred to change the plan, e.g. developing a complication. Patients look very limited for the first 48 hours. However, they pick up speed quickly and most patients can go home safely. By the end of 3 weeks, patients are able to:

• Walk 1/2 block
• Get in and out of bed, chairs and cars independently
• Eat, bathe, use the toilet, and dress themselves
• Go up and down stairs

Most patients are fearful of home discharge for the first several days after surgery. They need reassurance that the correct decision has been made and that their recovery will be supported through the homecare agencies as effectively as a skilled care facility. Using our criteria very few patients require change in the original plan.