The number of total knee and hip arthroplasty is predicted to rise 174% and 673%, respectively, over the next 20 years due to the expected rise in the baby boomer population. Along with increased numbers or procedures performed is the rise in cost and potential medical complications from hospitalizations. The purpose of this study is to describe one rural hospital's facility-wide procedure to streamline processes and standardize care without compromising patient medical needs prior to, and during, the acute phase of total knee and hip arthroplasty. Data were compared before and after the facility-wide procedure was implemented. Results found shorter length of hospital stay and significantly more discharges directly home all without increasing medical complications after the facility-wide procedure was implemented.