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HCA Healthcare’s commitment to delivering safe, high-quality care

HCA Healthcare nurses in scrubs

HCA Healthcare’s approach to ensuring high-quality care is rooted in our belief of always doing what is right for our patients. From our more than 36 million annual patient encounters, we develop and share best practices across our enterprise that help continuously improve patient care, using evidence-based guidance, tools, measurement, advanced analytics and data science to support safe, effective, compassionate care.   

Our organization has a long history of prioritizing and working to continually improve patient safety, including:

  • Establishing a Patient Safety Organization (PSO) to improve patient safety and the quality of healthcare delivery by partnering with colleagues at HCA Healthcare facilities to build systems, refine processes and foster a culture of safety.
  • Developing evidence-based perinatal protocols through our longstanding partnership with March of Dimes, such as prohibiting elective delivery prior to 39 weeks to help babies have a healthy start to life. This best practice has now been adopted worldwide as a standard of care. HCA Healthcare also worked to identify and develop solutions for top perinatal safety risks including preeclampsia, deep vein thrombosis (DVT) and pulmonary embolism (PE) in C-Section deliveries, and post-partum hemorrhage.
  • Hosting the REDUCE MRSA study, with nearly 75,000 patients across 43 HCA Healthcare hospitals, found that using antimicrobial soap and ointment to decolonize all ICU patients reduced bloodstream infections by 44% and MRSA by 37%. The CDC has since adopted this practice.
  • Conducting the ABATE Infection Trial at 53 HCA Healthcare hospitals with 330,000 patients in 194 non-ICU units, which found an infection control technique achieved a 31% reduction in bloodstream infections and nearly a 40% reduction in antibiotic-resistant bacteria among non-ICU patients with central line catheters and lumbar drains.
  • Developing the Sepsis Prediction and Optimization of Therapy (SPOT) tool, a system to help clinicians more quickly identify patients with sepsis.
  • Building upon the capabilities of SPOT technology to further develop our Next-gen Analytics for Treatment and Efficiency (NATE) platform during the COVID-19 pandemic. NATE brings analytic insights to assist clinicians in applying the appropriate clinical protocol for mechanically ventilated patients. This helped us decrease the length of stay and increase COVID-19 survival in HCA Healthcare facilities by 28%.
  • Reducing HCA Healthcare’s average door-to-needle time to 34 minutes for stroke care, which is faster than the national goal.

Awards and recognition for quality care

In 2022, our organization’s commitment to patient safety and quality was recognized nationally by leading benchmarking institutions, including:

The Leapfrog Group’s Hospsital Safety Grade

In its fall 2022 Hospital Safety Grade, The Leapfrog Group recognized 81% of HCA Healthcare hospitals with an A or B rating, as compared to 57% of hospitals nationally. Twice a year, The Leapfrog Group assigns an “A,” “B,” “C,” “D” or “F” Safety Grade to general hospitals across the country based on how well they protect patients from preventable medical errors, accidents, injuries and infections.

Merative 100 Top Hospitals 2022 

Twenty-four HCA Healthcare hospitals were recognized on the 2022 Fortune/Merative 100 Top Hospitals list. This was an increase from the 16 HCA Healthcare hospitals recognized in 2021. Last year, 2,650 short-term, acute care and non-federal U.S. hospitals were evaluated, narrowing to the Top 100 Hospitals list by reviewing clinical outcomes, operational efficiency, financial health and patient experience. Compared with peer hospitals, the facilities included on the list had better survival rates, fewer patient complications, fewer hospital-wide readmission rates and higher ratings of their overall health experience.

Healthgrades’ 2023 Specialty Excellence Award™ 

Healthgrades recognized 23 HCA Healthcare hospitals as recipients of its Specialty Excellence Award™ for delivering superior patient outcomes. Out of the 50 hospitals recognized, 46% were HCA Healthcare hospitals. The methodology for selecting award recipients uses Medicare Provider Analysis and Review (MedPAR) data from 2019 to 2021, and analyzes risk-adjusted mortality and complications for 15 common in-hospital surgical procedures. 

U.S. News & World Report’s Best Hospitals  

U.S. News & World Report recognized 14 HCA Healthcare facilities in its Best Regional Hospitals ranking for 2022-23. Nine of those facilities were ranked in the top three for their metro area. Within a state or metro area, regional hospital rank is determined by a hospital’s performance in the adult specialty rankings analysis and by its scores across each of the ten procedure and condition areas that U.S. News & World Report analyzes.

Best Hospitals for Maternity Care 

Eleven HCA Healthcare hospitals were named to Money and the Leapfrog Group’s Best Hospitals for Maternity Care list. To qualify, hospitals were required to earn an “A” or “B” letter grade on the Leapfrog Hospital Safety Grade assessment for spring 2022. Additionally, the hospitals that earned spots on the list include those that provide care for uncomplicated pregnancies, as well as hospitals that provide care for high-risk deliveries, such as offering neonatal intensive care units, etc.

Related article: 32 HCA Healthcare facilities earn top marks in 2022 Press Ganey Human Experience Awards

Reducing opioid usage and improving surgical outcomes  

HCA Healthcare’s Enhanced Surgical Recovery (ESR) program is a patient-centered, research-based, multidisciplinary approach to surgical recovery that allows patients to play an active role in managing their own care and recovery plan. The program implements select interventions before, during and after surgeries to improve patient outcomes.  

Based on data collected from more than 140,000 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: 

Related article: HCA Healthcare sets record by collecting 19,423 pounds of medication during fourth annual Crush the Crisis

Supporting the quality infrastructure for better patient outcomes

Headshot of Elizabeth Mikula
Elizabeth Mikula, Vice President of Quality for HCA Healthcare’s Capital Division

Hospitals across HCA Healthcare have dedicated quality teams that help ensure we are monitoring multiple patient care elements, quality metrics and outcome measures for the delivery of safe, high-quality care. These teams evaluate and ensure that evidence-based clinical practices are implemented – and reinforce HCA Healthcare’s commitment to continuous improvement in patient care.

As the Vice President of Quality for HCA Healthcare’s Capital Division, Elizabeth Mikula is responsible for supporting hospital quality teams as they implement quality and patient safety initiatives. Under her guidance, 17 of 18 eligible hospitals received an “A” on their Spring 2022 Leapfrog Patient Safety Score.

Elizabeth began her career as a registered nurse and was introduced early in her career to the incredible impact a quality initiative can have while working on efforts around newborn screening for critical congenital heart disease (CCHD). “I worked with a team to research and develop tools to support CCHD screening, which was ultimately implemented around the world and improved detection of CCHD,” said Elizabeth. “Through this work I realized I wanted to pursue roles in healthcare quality, where you can impact large populations of patients at a time.”

Today, Elizabeth leads the continuing development of the quality infrastructure across HCA Healthcare’s Capital Division, which is comprised of 18 facilities in Virginia, Indiana and New Hampshire. She works alongside the Division Chief Medical Officer and Quality Team to oversee clinical operations including direction, analysis and management of initiatives and projects at the system and facility level, with a specific focus on coordinating system regulatory compliance and support of quality-related teams. “Our leaders at the bedside and in the administrative offices are incredibly smart and passionate,” adds Elizabeth. “I am energized by and learn from them on a daily basis.”

Elizabeth is also instrumental in emergency management activities across the division. “There are few things more impressive than to see HCA Healthcare respond to a national disaster, such as a hurricane or global pandemic.”

“Throughout the COVID-19 pandemic, I was prouder than ever to work for a company that makes the needs of its facilities and colleagues the main priority and ensures they have the resources to provide patient-centered care for our communities in the midst of any emergency.”

ELIZABETH MIKULA, Vice President of Quality for HCA Healthcare’s Capital Division

About HCA Healthcare

HCA Healthcare, one of the nation's leading providers of healthcare services, is comprised of 182 hospitals and more than 2,300 sites of care, in 20 states and the United Kingdom. Our more than 283,000 colleagues are connected by a single purpose — to give patients healthier tomorrows.

As an enterprise, we recognize the significant responsibility we have as a leading healthcare provider within each of the communities we serve, as well as the opportunity we have to improve the lives of the patients for whom we are entrusted to care. Through the compassion, knowledge and skill of our caregivers, and our ability to leverage our scale and innovative capabilities, HCA Healthcare is in a unique position to play a leading role in the transformation of care.

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