Nashville, Tenn.-based HCA Healthcare, a healthcare provider with over 2,300 ASCs, has launched a new recovery program, the enhanced surgical recovery program, to decrease opioid usage among patients following procedures.
The program has been adopted by 167 HCA facilities, and it reduces hospital stays by two days on average, according to a Dec. 13 press release. The program also decreases opioid use by up to 44 percent for some surgeries.
Over 2 million patients have been a part of the enhanced surgical recovery program to date.
The program focuses on six tactics, used before, during and after operations:
1. Goal-directed fluid therapy: monitoring patient's fluid balances for hydration throughout surgery.
2. Patient education: equipping patients with their own personal recovery checklists.
3. Multimodal pain management: individualized approaches to pain, only using opioids as needed.
4. Permissive preoperative hydration and carb loading: helping patients to consume fluids and carb-rich drinks before surgery to curb nausea.
5. Drink, eat and mobilize: encouraging patients to drink, eat and move within 24 hours of the procedure.
6. Multidisciplinary team: creating a care team, including pharmacists, anesthetists and nurses, for each patient to lead them in their recovery journey.
HCA created these protocols using data from over 35 million patient encounters. The system has also invested $20 million into monitoring equipment to expand the program.
"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," Randy Fagin, MD, chief medical officer of HCA's national group, said in the release. "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."