The face of joint replacement surgery is changing quickly. An aging, more active population, combined with technological advances in orthopaedic devices and care, has resulted in a growing number of physicians recommending joint replacement surgery as a proactive intervention and not one of last resort for those with debilitating joint disease. Given the current trend and the anticipated increase in surgical volume associated with it, the need for an evidence-based, comprehensive, and well-coordinated Bone & Joint Program to provide patients and their families with the highest quality of care was clear. This is an article about how Hallmark Health System, 370-bed, community-based hospital system, north of Boston, MA, utilized the expertise of a skilled nurse to lead the way. Now, just over a year old and using an interdisciplinary team approach, the Bone & Joint Program at Hallmark Health is already returning dividends in patient satisfaction and in the hospital's bottom line.