Partnering with patients to improve outcomes.

At HCA Healthcare, we are continuously moving forward, driven by the constant pursuit of our mission to care for and improve human life. Clinical excellence means we deliver high quality care that is efficient for our patients and emphasizes leadership, training, technology, innovation, partnerships, and measurement systems. Leveraging our technology, scale and clinical expertise to share best practices, HCA Healthcare discovered that, by making a few key changes, we can significantly improve a patient’s surgical experience with less likelihood of surgical complications.

Enhanced Surgical Recovery

Enhanced Surgical Recovery (ESR) is a patient-centered, research-based, multidisciplinary approach that uses selected preoperative, intraoperative and postoperative interventions to optimize outcomes and the patient experience. With more than 20 years of clinical research, peer-review and analysis, ESR programs have demonstrated significant reductions in length of stay (LOS), blood loss, time to ambulation and complications, while increasing patient satisfaction. Just as important, ESR programs utilize multi-modal, evidence-based treatments in order to keep surgical pain well controlled while limiting the need for strong pain medications. Benefits of ESR include:

  • Faster recovery
  • Fewer complications
  • Minimized opioid use
  • Shortened hospital stay
  • Improved outcomes

Benefits of ESR at HCA Healthcare

HCA Healthcare leverages its technology, scale and unprecedented access to data to share best practices that refine and improve the ESR programs currently in use. Our simplified, data-centric initiative drives superior outcomes for patients, clinicians and hospitals by employing a simplified approach that utilizes five key tactics shown to have the greatest impact on improving patient outcomes.

  • Goal directed fluid therapy
  • Patient education
  • Multimodal pain management
  • Permissive preoperative hydration/carb loading
  • DREAM (drinking, eating and mobilization) within 24 hours post operation

HCA Healthcare is a Learning Health System that uses its scale and expertise to analyze data from patient encounters to continually improve care. Based on data collected from nearly 50,000 joint replacement, gynecologic oncology, colorectal and bariatric surgeries*, the HCA Healthcare ESR protocol has shown to be a proven roadmap to enhance surgical results and patient satisfaction as indicated by the results listed below.

Faster Recovery and Shortened Hospital Stay

  • Up to 3.63 day average reduction in length of stay
  • Nearly 59,000 less days in the hospital for patients recovering from surgery

Improved outcomes

  • 6.2% increase in patient’s pain goal being met
  • 37.93% decrease in complication rate

Fewer complications

  • 28.8% decrease in 30 day readmissions
  • 26.74% decrease in 90 day readmissions

Decreased opioid use

  • Up to a 50% decrease in total morphine equivalence per encounter
  • 1.57 million less morphine medications dispensed

From the physician’s office prior to surgery and through to follow-up care, HCA Healthcare’s ESR program allows patients to play an active role in managing their own care plan.

* January 1, 2019 – December 31, 2019

Download our Enhanced Surgical Recovery Information