OBJECTIVES: Hospital Parc Taulí and Johnson & Johnson, partnered in a program to design and implant a fast track program for knee joint replacement. The objective was to decrease morbidity, functional convalesce, length of stay and increase patient and professionals satisfaction efficiently.    METHODS: The implementation included 3 phases and two multidisciplinary Workgroups. Clinical aspects based on evidence, combined with organizational optimization, resources distribution and process redesign. Phase I: evaluation, nourished by Kaizen methodologies, Lean and 6 Sigma processes, Blum and Taylor laborer environment and Alex Faicknet Osborn group dynamics were taken under consideration. Phase II: Implantation, using Taylor dynamics to define the strategies to produce improvement on target indicators. Phase III: Monitoring, both from length of stay, security aspects such as morbidity, mortality, readmission rates, patient and professional satisfaction, and economic impact. RESULTS: The length of stay is influenced by factors such as patient profile and organizational aspects. Empowered patients are more active. A new patient pathway was developed, initiated when admitted to discharge and post-operative follow up. Improvement on healthcare results, increasing patient and professional’s satisfaction, and reducing 50% length of stay, resulting on significant economical savings. CONCLUSIONS: Analyzing the patient pathway through an analysis methodology, reingeniery and diagnosis healthcare process (in outcomes and in direct cost), the patient involvement in the whole process can result not only in important efficiency improvement, but also improve the working environment and enhanced team work culture for a continuous process improvement.