OBJECTIVES: The surgical management of vesicoureteral reflux consists of open and minimally invasive approaches. Open approaches are associated with postoperative hospitalization rates of stay typically 2 to 3 days, varying with the type of procedure. We evaluated the impact of a “ one night cost-saving stay process of care” model for open surgical correction of vesicoureteral reflux on quality of care, as defined by return to emergency room or office and/or readmission to the hospital within 2 days of discharge . METHODS: An IRB-approved  chart review of all open uncomplicated ureteral reimplantations for vesicoureteral reflux from the January 2009 through January 2013 was performed.   Length of postoperative stay, emergency room records, hospitalizations and office records were reviewed to assess for presentation to the emergency room/office and/or readmission to the hospital within 2 days of discharge from the ureteral reimplantation. RESULTS: : 95 children (17 males, 78 females)  underwent open ureteral reimplantation. Eighty four (88.4%) were discharged POD #1 , 8 (8.4%) on POD #2 and  3 (3.2%) on the POD #3.  Two patients presented to the ER within 2 days of discharge, one in the one night stay group and one in the three night stay group. No child required readmission within 2 days of discharge.  Transient ureteral obstruction requiring stent placement occurred in 1 patient (1.05%)  3 days after discharge. Presentation to the ER > 2 days post-discharge was more frequent in those discharged from home POD #1. CONCLUSIONS: A process of care model decreased the length of stay to one night in 84 of the 95 patients (88.4%) and did not appear to increase the risk of early (within 2 days of discharge) presentation to the ER/office or readmission.  ER/office presentations > 2 days after discharge were increased in the POD #1 group.