clinical pathways and
make needed adjust-
ments as they gain
more experience in
managing the entire
episode of care.
"When surgeons first
start performing out-
patient total joints,
they should select
healthier, more active
patients and focus on
perfecting their surgi-
cal techniques and
overall program," says
Dr. Shah. "As their
skills improve and the
facility's clinical path-
ways become more
refined, the percent-
ages of patients who
are ready for same-day
discharge will grow."
• Skilled surgeons.
If patient selection is
the top consideration
in the success of out-
patient total joints,
surgeon skill is a close
second. Dr. Shah says
LUER
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1 Vallejo M. C., Mandell G. L., Sabo D. P., Ramanathan S. Postdural Puncture Headache: A Randomized
Comparison of Five Spinal Needles in Obstetric Patients 2000; Anesth. Analg, 2000; 91:916–20
2 Hong X., Yang L., WenYe S., ShunLi K., FeiFei L., Di Z., GuangZhi N., ShiQing F. Comparison of Cutting and Pencil-Point
Spinal Needle in Spinal Anesthesia regarding Postdural Puncture Headache: A Meta-Analysis 2017: Medicine 96:14 www.md-journal.com
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