1223 Physiotherapy’s Crucial Role in Early Elective Post-Operative Orthopaedic Discharge - One More Night?

Aim

Physiotherapy (PT) is essential post operatively in optimizing patient mobility. However, patients admitted to the wards in the evening may not benefit from same day post-operative mobilization. Subsequent overnight hospital stays are common.

We aimed to investigate whether same day mobilization with physiotherapy reduced length of hospital stay. We hypothesized that failure to reach mobility milestones delayed discharge and earlier physiotherapy intervention could reduce overnight stay/hospital duration.

Method

We retrospectively evaluated patient records and operating notes for all patients undergoing elective lower limb arthroplasty procedures under one operating hospital team, during April 2022. 38 patient records were analysed.

Results

Medical complications (particularly fatigue, wound issues, pain, and blood pressure control) commonly delayed discharge (31.6%) and affected engagement with physiotherapy. 55.3% experienced post operative pain affecting engagement with physiotherapy, blood pressure and fatigue being other factors. 92.1% of patients had same-day physiotherapy input of some form (such as pre-operative assessment), whilst 76.3% had same day post-operative PT assessment. Most patients required further PT assessments (92.1%) - of the patients who stayed overnight (92.1%), only 17.1% had same day post-operative physio assessment.

Conclusions

Optimising commonly encountered post operative complications is vital as medical complications often delayed discharge and affected engagement with physiotherapy.

Notably, the majority of patients (68.4%) were discharged from hospital less than a day after being discharged from inpatient PT, suggesting that patient mobility/PT engagement may be the limiting factor affecting discharge.