Your surgery has a date. Preparation is the part that's yours.

Nobody hands you one list

Preparing one patient for joint replacement takes an estimated 8.45 hours of clinical staff work spread across the surgeon's office, primary care, specialists, the lab, the facility, and the insurer (Constantinescu 2022). The information moves by fax, portal message, and phone call — and the patient is often the messenger carrying it between offices. When a piece goes missing, it is usually discovered late: a blood thinner that was never stopped, a cardiology note nobody can find, a ride home that was never arranged. Studies of structured preoperative evaluation show that finding these problems early reduces cancellations and delays (Ferschl 2005); a cancelled operation wastes most of its cost after the patient has already done the preparing (Mangan 1992).

The work is real, and some of it takes weeks

Some preparation is paperwork. Some is medicine: anemia and smoking, for example, are each associated with worse outcomes after surgery, and both can improve before surgery when there is time to act (Fowler 2015; Mills 2011). In one published optimization program, one in five patients never completed the recommended preparation before their operation (Bernstein 2018) — not because they didn't care, but because nobody could see the whole picture in one place. Professional guidance on the timing of surgery makes the same point from the other side: readiness is individual, and it is managed, not assumed (Hannon 2023).

Documentation and clearances

The history and physical exam, surgical consent, medical clearance, current lab results, an EKG when required, and insurance authorization. Each has its own owner and its own expiration date — a clearance that was current in March may not be current on a June surgery day.

Medications

A reconciled list with exact stop dates. Blood thinners, diabetes medications, weight-loss injections, and some supplements each have their own rules, and the instructions have to come from your surgical team — the Readiness Score gives you the list to put in front of them.

Home and logistics

Transportation on surgery day, the person staying with you the first nights, equipment at home, and the discharge plan. This is the part only you can arrange, and the part most often discovered missing at the last moment.

Education

What surgery day asks of you — arrival time, fasting, bathing protocol — and what the first days after look like. Preoperative education measurably reduces anxiety around surgery (Lloyd 2026), and it is the cheapest preparation there is.

Eight parts, each worth the same

The TJV Readiness Score walks all of this as one guided pathway and scores it out of 100 — 8 parts at 12.5 points each. Reporting a health condition never lowers your score: points are only ever waiting on unfinished work, never subtracted for your health. The result is a single number that answers “am I ready for surgery day?” and shows exactly which part to work on next.

• Medical optimization. The health conditions that matter before anesthesia — reported, and where they can be improved, worked on with your own doctors.
• Medical clearances. Which specialists need to sign off for your situation, and the forms that ask them the right questions.
• Medication review. Every medication listed, with what stops, what continues, and the exact dates — the single most common surgery-day surprise.
• Additional testing. The blood panel and EKG most surgical teams require, with when to get them so the results are still current on surgery day.
• Home and social support. Who stays with you the first nights, who drives you there and back, and whether your home is set up for the first week.
• Mobility and recovery support. Falls, assistive devices, and the strength to get out of a chair — what therapy will build on from day one.
• Expectations. What a good result means to you, written down — because satisfaction after surgery tracks what you expected before it.
• Education. What surgery day actually asks of you: arrival, fasting, bathing, and the plan for the first days after.

Check readiness →

Free, and no account is needed to work through it. Signing in lets you save the score to a private record and, if you choose, share it.

Two ways the score works — and the difference matters

With any surgeon, anywhere: the Readiness Score is yours. You track your own preparation — medications listed, testing dated, home support named, education done — and bring the result to your pre-op visit so your surgical team can confirm it against their own checklist. It replaces the pile of sticky notes, not your surgical team.

With a participating surgical team: your team sees the same score you do, confirms each part, requests clearances for you, and tracks everything against your surgery date — so a problem is found while there is still time to fix it, not on surgery day. If your surgeon participates in JointVoyage, the two views are one record.

The page never blurs the two: a score your surgical team has not confirmed is your own careful tracking, and this site will always say which one you are looking at.

For surgical teams

JointVoyage prepares your patient for surgery — clearances, medication reconciliation, home setup, and education, scored as the eight-part TJV Readiness Score and visible to you and the patient together. See the physician workspace →