Implementing the Rapid Recovery Program in primary hip and knee arthroplasty in a UK state run hospital

The Rapid Recovery Program (RRP) is an accelerated discharge programme aimed at reducing the length of stay (LOS) and improving patient satisfaction. Its principles are discussed, and our early experience of 847 hip and knee arthroplasty patients described. Three groups were identified: Pre-RRP implementation (Pre-RRP), Post-RRP implementation who did not attend our pre-operative educational Joint Replacement School (JRS) (RRP-JRS) and Post-RRP who did attend JRS (RRP + JRS). Mean LOS (days) for hip arthroplasty was 11 (Pre-RRP), 6.4 (RRP + JRS) and 8.7 (RRP-JRS) (P < 0.05). Mean LOS (days) for knee arthroplasty was 8.5 (Pre-RRP) (P < 0.05), 5.9 (RRP + JRS) and 5.8 (RRP-JRS). RRP reduced LOS and pre-operative education further reduced LOS in hip arthroplasty. We believe these effects are produced by streamlining perioperative processes, education and improving patient experience.