Prehabilitation Impact on Post-operative Risk, Readmission Rates and Patient Satisfaction

Background: Prehabilitation programs may improve 30-day readmission rates, post-operative infections and patient satisfaction in obese total joint replacement (TJR) patients. Joint replacement patients who participate in prehabilitation have improved physical function and patient satisfaction. In an effort to improve TJR patients’ mobility and recovery, a prehabilitation performance improvement project was implemented at a local wellness center. Method: The Institute of Healthcare Improvement, Triple Aim Initiative (IHI, TAI) and Centers for Medicare and Medicaid (CMS) performance improvement goals provided the project foundation (IHI, 2015; CMS; 2015). The physical exercise routine utilized in this program was identified as appropriate for use with the TJR population (Topp & Page, 2009). The development of an evidence based prehabilitation program for the purpose of reducing post-operative mortality and improving patient satisfaction was supported by the literature. Results: The project outcomes include a 7% improvement in overall patient satisfaction rates, and a 0.8 % reduction in post-operative infection rates. Conclusion: The prehabilitation Scholarly Project served to inform future efforts of similar sustainable programs fulfilling the IHI and CMS goals of quality, affordable, and accessible health care (IHI, 2015; CMS, 2015). The data supports prehabilitation’s ability to positively impact patient satisfaction and post-operative infection rates among obese TJR patients. Key Words: obesity, prehabilitation, joint replacement, post-operative complication