Introduction: Although the clinical attributes of total hip arthroplasty (THA) care pathways have been thoroughly researched, a detailed understanding of the equally important organisational attributes is still lacking. The aim of this article is to contribute with a model of the outpatient THA care pathway that depicts how the care team should be organised to enable patient discharge on the day of surgery. Theory: The outpatient THA care pathway enables patients to be discharged on the day of surgery, shortening the length of stay and intensifying the provision and organisation of care. We utilise visual care modelling to construct a visual design of the organisation of the care pathway. Methods: An embedded case study was conducted of the outpatient THA care pathway at a teaching hospital in the Netherlands. The data were collected using a visual care modelling toolkit in 16 semi-structured interviews. Problems and inefficiencies in the care pathway were identified and addressed in the iterative design process. Results: The results are two visual models of the most critical phases of the outpatient THA care pathway: diagnosis & preparation (1) and mobilisation & discharge (4). The results show the care team composition, critical value exchanges, and sequence that enable patient discharge on the day of surgery. Conclusion: The design addressed existing problems and is an optimisation of the case hospital’s pathway. The network of actors consists of the patient (1), radiologist (1), anaesthetist (1), nurse specialist (1), pharmacist (1), orthopaedic surgeon (1,4), physiotherapist (1,4), nurse (4), doctor (4) and patient application (1,4). The critical value exchanges include patient preparation (mental and practical), patient education, aligned care team, efficient sequence of value exchanges, early patient mobilisation, flexible availability of the physiotherapist, functional discharge criteria, joint decision making and availability of the care team.

Care pathways are used in hospitals to manage the decision making and care processes across medical specialities. The latest innovation in hip replacement is a care pathway that enables a patient discharge on the day of surgery. While the clinical attributes have been well researched a detailed understanding of the organisation is missing. We apply business modelling to create an organisation model of the care pathway and translate the embedded knowledge to other hospitals. A case study was conducted of the outpatient THA care pathway at a teaching hospital in the Netherlands. We present two visual models of the critical phases of the care pathway, with which we add the organisational attributes to support adoption of the innovation to other hospitals. Designers design business models for services. However more examples of practice are needed to contribute to the knowledge base of business modelling toolkits. In this paper we apply business modelling in the domain of healthcare.