HCA Healthcare’s Innovative Approach to Surgical Recovery Promotes Better Outcomes, Decreased Opioid Usage and Faster Recovery Times for Patients
13 Dezember 2022 - 02:30PM
Business Wire
HCA Healthcare, Inc. (NYSE: HCA), one of the nation’s leading
healthcare providers, today announced its enterprise-wide adopted
Enhanced Surgical Recovery (ESR) program, a patient-centered,
research-based, multidisciplinary approach to surgical recovery.
The ESR program has been adopted by 167 HCA Healthcare facilities
and has demonstrated significant improvements in surgical recovery,
including a two-day average reduction in length of hospital stays
and an up to 44% decrease in opioid usage for some surgeries.
“After studying more than 20 years of clinical research and
peer-reviewed publications in addition to our own internal data, we
discovered that a facility making a few key changes, such as using
multimodal approaches to managing pain and encouraging patients to
eat and walk around within 24 hours after surgery, can have a
significant impact on a patient’s recovery,” said Dr. Randy Fagin,
Chief Medical Officer of HCA Healthcare’s National Group. “From the
physician’s office prior to surgery to follow-up care, a facility’s
ESR program allows patients to play an active role in managing
their own care and recovery plan.”
ESR uses select pre-, intra- and post-operative interventions
designed to improve outcomes and the patient experience. The
program was derived from Enhanced Recovery after Surgery (ERAS), a
recovery program that has been standard practice in Europe for a
number of years and consists of up to 21 components. HCA
Healthcare’s ESR focuses on the six tactics believed to have the
greatest impact on patient outcomes:
- Goal-directed fluid therapy: active monitoring of a
patient’s fluid balance to achieve an optimal hydration level
throughout surgery.
- Patient education: equipping patients with a personal
recovery checklist so they can play an active role in their
care.
- Multimodal pain management: an individualized approach
only using opioids on an as-needed basis and instead using
non-opioid pain relievers and other pain management
techniques.
- Permissive pre-op hydration/carb loading: drinking
fluids and a carbohydrate-rich drink before surgery to improve
hydration and insulin resistance as well as to curb nausea.
- DREAM = drink, eating and mobilization within 24 hours
post-op: encouraging patients to drink, eat and move shortly
after their surgery.
- Multidisciplinary team: creating a group of team
members, including a surgeon champion, an anesthesia champion,
nursing and pharmacy, who work together to guide the facility’s
program and each patient’s care journey.
Jared Stockett, a double knee replacement patient at HCA
Healthcare’s West Valley Medical Center, is one of more than two
million patients who have participated in the ESR program adopted
by facilities throughout HCA Healthcare. “The surgeries went really
well. Each time I went in at 8 a.m., the surgery started around 10
a.m. and I went home around 3 p.m. that afternoon. By the time I
left the hospital, I had already been up and walking with a
walker,” said Stockett. “Three days after each surgery, my knee
already felt better. By following the instructions from my care
team, recovery went very smoothly.”
As a learning health system, HCA Healthcare uses data from
approximately 35 million annual patient encounters to share best
practices and focus on continuously improving care. Based on data
collected from 141,482 joint replacement, gynecologic oncology,
colorectal and bariatric surgeries in 2021, the ESR protocol has
shown to be a proven roadmap to help improve surgical results,
including:
- A 2.1-day reduction in length of stay;
- A 54% decrease in 30-day readmissions for joint
replacements;
- A 45% decrease in 90-day readmissions for gynecological
surgery;
- Up to a 44% decrease in opioid usage; and
- 2.4 million fewer morphine medications dispensed.
Based on these outcomes delivered to patients, HCA Healthcare
invested an additional $20 million in monitoring equipment to
support expanding the program to other surgical service lines in
2021.
About HCA Healthcare
Nashville-based HCA Healthcare is one of the nation’s leading
providers of healthcare services comprising 182 hospitals and
approximately 2,300 ambulatory sites of care, including surgery
centers, freestanding ERs, urgent care centers, and physician
clinics, in 20 states and the United Kingdom. With its founding in
1968, HCA Healthcare created a new model for hospital care in the
United States, using combined resources to strengthen hospitals,
deliver patient-focused care and improve the practice of medicine.
HCA Healthcare has conducted a number of clinical studies,
including one that demonstrated that full-term delivery is
healthier than early elective delivery of babies and another that
identified a clinical protocol that can reduce bloodstream
infections in ICU patients by 44%. HCA Healthcare is a learning
health system that uses its more than 35 million annual patient
encounters to advance science, improve patient care and save lives.
Please click here to connect with HCA Healthcare on social
media.
All references to “Company,” “HCA” and “HCA
Healthcare” as used throughout this document refer to HCA
Healthcare, Inc. and its affiliates.
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