Problem: An estimated 85% of patients undergoing a total hip arthroplasty (THA) were experiencing spinal-induced hypotension (SIH) at a small community hospital in Maryland. Additionally, 100% of patients who received a THA at this community hospital were over age 60 and were known to experience SIH at higher rates. Purpose: The purpose of this quality improvement (QI) project was to reduce the incidence of SIH among elderly patients over the age of 60 undergoing a THA at a small community hospital in Maryland by implementing an SIH bundle including a crystalloid co-load of 10ml/kg, 4 mg of intravenous ondansetron administered five minutes before the spinal anesthetic, and a low- dose, weight-based phenylephrine infusion started at the time of the spinal anesthetic. Methods: The Project Lead constructed a three-part SIH bundle approved by the anesthesia department leadership and the clinical site representative (CSR). Bundle education was provided in person and virtually for all 37 anesthesia providers. Immediately following education, anesthesia staff administered the three-part bundle, including a 10ml/kg crystalloid fluid co-load, 4 mg of intravenous ondansetron administered five minutes before the spinal anesthetic, and a low dose weight-based phenylephrine infusion started at the time of the spinal anesthetic. Bundle compliance with each intervention was measured via retrospective chart audits by the Project Lead and disseminated weekly to staff. All THA patients over 18 receiving spinal anesthesia are included in the data collection. Results: To date, 191 patients were eligible for inclusion in the project data. Providers were fully compliant with all three interventions on 44 patients. The intervention with the lowest median compliance rate of 17.5%, was the initiation of the phenylephrine drip. Implementation of the 10ml/mg crystalloid co-load and the administration of 4mg of ondansetron five minutes before the spinal significantly reduced the need to initiate the phenylephrine drip. By the conclusion of the project implementation, overall SIH bundle compliance rates achieved a median rate of 71.5%. Conclusions: The findings suggest implementing an SIH bundle was feasible. The SIH bundle, concurrently implemented with stakeholder buy-in and effective implementation strategies, sustained a successful evidence-based practice change.