A preoperative program was initiated by the nursing staff of an orthopaedic unit to prepare patients and their families by providing information about every aspect of hospitalization for total joint replacement in order to decrease length of stay (LOS) and improve patient satisfaction. This included steps to minimize complications, teaching exercises that would increase post operative function, and quality discharge planning. The program is coordinated by the Patient Care Managers (PCM) and is offered to 4 patients twice weekly. The sample consisted of 463 patients admitted for total hip and knee replacement. The average LOS during the 33-month period was 8.0 days for those patients who received the preoperative program and 8.7 days for those patients who did not. Several outliers that had extended hospitalizations were equally distributed in both groups. By providing education preoperatively, we have not only reduced costs, but we have also provided our patients with timely information and quality care.