The gap between booking surgery and admission

A patient books a joint replacement. You schedule the procedure. You send them home with advice to stay active, lose weight if needed, and prepare for surgery.

Then what?For most surgical practices, the answer is: nothing structured. The patient manages their preparation on their own, and you see them again at pre-admission, usually a week or two before the procedure.

That gap, typically 6 to 12 weeks for elective orthopaedics, is where patient outcomes are quietly decided. And most surgical practices have almost no visibility into what happens during it.

What actually happens in the gap

When a patient leaves your consulting room with a surgery date, they're typically optimistic. They've made a decision. They have a plan. They know what's coming.

But over the next few weeks, a predictable set of things tend to happen.

Some patients do well. They stay active. They follow the advice. They arrive for surgery in good shape.

Many don't. Not because they're non-compliant or uninterested, but because managing pre-operative preparation without structure or support is harder than it sounds.

Pain flares. Motivation drops. They're not sure if what they're experiencing is normal. They're uncertain whether they're doing the right exercises, or doing them correctly. They read something online that makes them anxious. They start second-guessing the decision.

Some patients call your practice. Often. Your surgical coordinator fields questions about whether the pain they're feeling means something's wrong, whether they should still be exercising, whether it's normal to feel nervous, whether they can take a particular medication.

Other patients don't call. They just quietly reduce their activity, hoping the pain settles. By the time they arrive for pre-admission, their function has deteriorated rather than improved, and you're seeing that baseline for the first time.

Why this matters for outcomes

The evidence on prehabilitation is clear. Patients who enter surgery with better strength, mobility, and aerobic fitness have better post-operative outcomes. They recover function faster, experience fewer complications, and return to independence sooner.

But prehabilitation only works if patients actually do it. And most patients, left to manage it themselves, don't do it consistently.

The gap between booking and admission is where that failure happens. And because it happens at home, without oversight, surgical practices typically don't know how prepared, or unprepared, a patient is until they're admitted.

There's also a psychological dimension that gets less attention but matters just as much.

Patients who feel uncertain, unsupported, or anxious in the lead-up to surgery are more likely to be anxious on the day. They're more likely to need reassurance from your team. They're more likely to call the practice with non-urgent concerns. And they're more likely to interpret normal post-operative pain or stiffness as a sign that something's wrong.

Confident, well-prepared patients are easier to manage. They know what to expect. They trust the process. They follow protocols without needing constant reassurance. And when they do make contact, it's usually because something genuinely needs clinical attention.

The difference between those two patient profiles is often what happened, or didn't happen, in the six weeks before admission.

The visibility problem

Most surgical practices track the things that happen inside the system. Consultations. Imaging. Pre-admission appointments. Theatre bookings. Post-operative follow-ups.

What you typically don't track is what the patient is doing at home between those touchpoints.

Are they exercising? How much? Are they losing weight, or gaining it? Is their pain improving, stable, or worsening? Are they sleeping well, or lying awake worrying? Are they following your advice, or have they given up because it's too hard or they don't understand it?

Without structured visibility into that period, you're essentially flying blind until pre-admission. And by then, there's limited time to course-correct if something's gone wrong.

This is the core problem that digital surgical optimisation is designed to solve. It's not about replacing your clinical judgement or your team's involvement. It's about giving you visibility and continuity during the weeks when patients are on their own.

What structured support actually looks like

Beyond The Clinic's surgical pathway was tested in Project Mobilise across both public hospital and private specialist settings. The model pairs a digital program, delivered via the JointFit app, with active physiotherapist support via telehealth.

Patients are onboarded at the point of surgical decision, complete the Joint Health Profile to establish a baseline, and then move into a guided program tailored to their procedure and timeline.

The program delivers education in manageable stages, matched to where they are in the surgical journey. It provides structured exercises with motion-tracking to ensure they're being done correctly. It tracks progress, flags concerns, and escalates issues to the physiotherapy team, who in turn coordinate with the surgical team when needed.

From a practice perspective, this provides something you typically don't have: real-time visibility into whether a patient is engaging, whether they're hitting milestones, and whether there are red flags that need addressing before admission.

In the Project Mobilise surgical cohort, 88.2% of referred patients onboarded into the program. 90.0% were retained through the pre-operative and post-operative program window. Among patients who commenced, 100% reported feeling more confident prior to surgery.

Dr Jason Tsung, an orthopaedic surgeon at Southern Gold Coast Orthopaedics, uses the platform with his joint replacement patients. He reports that it gives him confidence that patients are managing their care according to his protocols, and that his practice team has noticed fewer routine calls from patients, because patients can access reliable, stage-appropriate information through the app rather than ringing the clinic every time they have a question.

For a busy surgical practice, that operational benefit is significant. Fewer non-urgent patient calls means your surgical coordinator and admin team can focus on the work that genuinely requires their expertise, rather than fielding questions that could be answered through structured patient education.

The shift toward outcome accountability

Australian healthcare is moving, slowly but steadily, toward value-based and outcome-based contracting. That shift is already visible in public hospital settings, and it will eventually reach private practice.

In that environment, the ability to demonstrate that your practice actively supports patient preparation, monitors engagement, and intervenes early when patients are struggling will no longer be optional. It will be part of how quality is measured and how contracts are structured.

The surgical practices that adapt early, building patient preparation into their standard workflow rather than treating it as a patient responsibility, will have a significant advantage when that shift accelerates.

There's also a reputational dimension. Patients increasingly expect digital tools as part of their care. They're used to apps that track progress, send reminders, and provide guidance. A surgical practice that offers structured digital support between touchpoints is perceived as more modern, more organised, and more invested in patient outcomes than one that sends patients home with a printed handout and hopes for the best.

What good looks like in practice

A well-designed surgical optimisation pathway should do a few specific things without adding burden to your practice team.

It should onboard patients at the point of surgical decision, so the gap between booking and admission is filled with structured support rather than unstructured waiting.

It should provide clear, stage-appropriate education so patients understand what to expect and what they need to do at each phase of the journey.

It should track engagement and progress, so you know which patients are doing well and which ones need additional support before admission.

It should escalate clinical concerns to your team in real time, so problems are caught early rather than discovered at pre-admission or, worse, on the day of surgery.

And it should integrate into your existing workflow without creating additional administrative burden, because the goal is to reduce work for your team, not add to it.

That's the model Beyond The Clinic has built for surgical practices. If you're preparing for the future of surgical care, or if you're simply tired of patients arriving for surgery less prepared than they should be, we'd welcome the chance to walk you through it.

You can also read the full Project Mobilise Outcomes Report to see the surgical cohort data in detail.

Key takeaways

• Most surgical patients spend 6–12 weeks between booking and admission with no structured support or oversight.
• During that gap, patient function and confidence can deteriorate, but surgical practices typically have no visibility until pre-admission.
• Patients who feel unsupported during the pre-operative period generate more non-urgent calls, arrive more anxious, and require more post-operative reassurance.
• Beyond The Clinic's surgical pathway achieved 90% retention in a real-world pilot cohort, with 100% of patients reporting improved confidence before surgery.
• Dr Jason Tsung reports fewer routine patient calls and better confidence that patients are following protocols.
• As healthcare moves toward outcome-based contracting, structured patient preparation will shift from optional to expected.

Ready to close the gap between booking and admission? Explore the surgical pathway or book a demo to see how it works in practice.