Day of surgery discharge success after implementation of a rapid discharge protocol following unilateral unicompartmental knee arthroplasty ☆ Cass K. Nakasone a,b , Dylan Combs c , Brian Buchner d , Samantha Andrews a,b, ⁎ a Straub Medical Center, Bone and Joint Center, Honolulu, HI 96813, United States of America b University of Hawai'i, Department of Surgery, Honolulu, HI 96813, United States of America c John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI 96813, United States of America d Straub Medical Center, Hospitalist, Honolulu, HI 96813, United States of America article info abstract Article history: Received 29 October 2019 Received in revised form 21 February 2020 Accepted 18 March 2020 Available online xxxx Background: Unilateral unicompartmental knee arthroplasty (UKA) is considered an outpatient procedure, however, previous research has reported a wide success rate range for day of sur- gery (DOS) discharge. Previous rapid discharge protocols (RDPs) have focused on pain manage- ment and nausea control but are commonly done in outpatient facilities, limiting the generalizability to the community hospital setting. Therefore, this study compared the rate of successful DOS discharge after the implementation of a RDP compared to the previous standard discharge protocol (SDP) following unilateral UKA. Methods: A retrospective chart review was completed for 174 unselected consecutive patients having undergone unilateral UKA between January 2016 and May 2018. The RDP was imple- mented in March 2017, with the addition of an arthroplasty dedicated hospitalist, a change to patient discharge expectations and a change to post-operative patient navigation. All other surgical and patient care procedures were identical for both groups. Results: Evaluation included 89 patients in the SDP group and 90 patients in the RDP group. Successful DOS discharge rate increased significantly from 11.2% for the SDP group to 72.2% for the RDP group (p = 0.000). Two patients from each group were treated with antibiotics for stitch abscess and no patient sustained a major complication within 90 days. Conclusions: Small, significant changes applied in the current study resulted in a significant in- crease in success of DOS discharge. These procedures can be easily implemented in all settings and may be more representative of the discharge capabilities for non-selected patients seen in the community hospital setting. © 2020 Elsevier B.V. All rights reserved. Keywords: Unicompartmental knee arthroplasty Rapid discharge Day of surgery discharge 1. Introduction Day of surgery (DOS) discharge following unilateral unicompartmental knee arthroplasty (UKA) has been reported to be highly successful and safe when performed in an outpatient surgical setting [1–5]. A few studies evaluating DOS discharge from an outpatient facility in a non-selected cohort have reported 100% success rates with low post-operative complications The Knee xxx (xxxx) xxx ☆ Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, and patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article. ⁎ Corresponding author at: Bone and Joint Center, Straub Medical Center, 888 S. King St., Honolulu, HI 96818, United States of America. E-mail address: samantha.andrews@straub.net. (S. Andrews). THEKNE-03015; No of Pages 6 https://doi.org/10.1016/j.knee.2020.03.003 0968-0160/© 2020 Elsevier B.V. All rights reserved. Contents lists available at ScienceDirect The Knee Please cite this article as: C.K. Nakasone, D. Combs, B. Buchner, et al., Day of surgery discharge success after implementation of a rapid discharge protocol following unilat..., The Knee, https://doi.org/10.1016/j.knee.2020.03.003