THE EFFECTIVENESS OF PRE-OPERATIVE EDUCATION ON DISCHARGE DESTINATION AFTER AN ELECTIVE TOTAL JOINT REPLACEMENT. Allison Stein*1; Denice Arthur2; Jeffery Wang2 1. Rehabilitation Services, UCLA Medical Center, Los Angeles, CA; 2. Orthopedic Surgery, UCLA Medical Center, Los Angeles, CA PURPOSE: To examine the impact of a multidisciplinary pre-operative education seminar on hospital discharge destination for individuals undergoing elective total joint replacement surgery. BACKGROUNDS/SIGNIFICANCE: Clinically appropriate discharge home following total joint replacement (TJR) surgery is associated with lower rates of nosocomial infection, decreased likelihood of medication errors, and is the preferred rehabilitative setting for many patients. We implemented an educational program to better prepare patients and caregivers for pending TJR, and examined the effect of the program on discharge setting. SUBJECTS: All individuals who underwent elective total hip or total knee replacement surgery were asked to complete a survey at their first post-operative clinic visit. One hundred sixteen individuals completed the survey; 63 who participated in the seminar, and 53 who did not participate in the seminar. The outcome of interest was the location the patient was discharged to. In addition to participation in the class, the survey gathered information about other potential predictor variables. Individuals that indicated on the survey that their total hip replacement surgery was the result of a fracture were excluded from the analysis. METHODS AND MATERIALS: All individuals undergoing elective total hip or total knee replacement surgery at the medical center were invited by flyer to attend a free pre-operative one-hour educational seminar when they received their pre-operative information. The seminar was conducted by an orthopedic acute care RN, PT, OT, Pharmacist, and Discharge Planner. ANALYSES: For purposes of analysis, the key outcome variable was dichotomized (discharge home vs. discharge to non-home setting). Bivariate analyses (chi2 or t-test as appropriate) were conducted to identify those variables significantly associated with discharge home. A logistic regression was then conducted to calculate odds ratios and examine whether participation in the class was significantly associated with a patient being discharged home, controlling for other predictor variables significant in the bivariate analysis. RESULTS: Subjects that attended the seminar were 2.5 times more likely to be discharged directly home (p=0.048), controlling for the floor the individual was on in the hospital. Subsequent analyses revealed a substantial difference by hospital floor. Individuals on the orthopedic floor in the hospital who attended the seminar were 1.8 times more likely to be discharged home than those who did not attend the seminar (p=0.24). However, patients who were on floors other than the orthopedic floor and attended the seminar were 8.6 times more likely to be discharged home than those who did not attend the seminar (p=0.07). CONCLUSIONS: Pre-operative education in the form of a multidisciplinary seminar may significantly increase the likelihood of a patient being discharged home following an elective total joint replacement surgery. Future research needs to examine the clinical outcomes of individuals discharged to different settings post-Total Joint Replacement. FUNDING SOURCE: UCLA Medical Center, Department of Rehabilitation Services KEYWORDS: Hospital Discharge, Pre-operative Education, Total Joint Replacement Copyright 2009 by the American Physical Therapy Association. Requests for reprints should be directed to the corresponding author of the article. Educators, students, and other academic customers may receive permission to reprint copyrighted material from Physical Therapy (ISSN 1538-6724) by contacting the Copyright Clearance Center Inc, 222 Rosewood Dr, Danvers, MA 01923. Other types of customers who want permission to reprint should contact the APTA Editorial Office, Attn: Physical Therapy.