U.S. Hospitals Achieve Significant Gains in Surgical Patient Outcomes Since 2019, AHA and Vizient Report Shows
In a compelling new report released jointly by the American Hospital Association (AHA) and Vizient®, researchers have found that outcomes for hospitalized surgical patients in the United States improved markedly in 2024 compared to those in 2019. These improvements span a range of key quality and patient safety metrics and suggest a sustained, system-wide commitment to enhancing inpatient surgical care — even amid ongoing post-pandemic pressures on healthcare systems.
The report underscores a major development in the trajectory of inpatient surgical care: not only have hospitals succeeded in reducing common complications such as infections and in-hospital falls, but they have also achieved statistically significant reductions in life-threatening conditions frequently associated with major surgical procedures, including severe bleeding (hemorrhage), sepsis, and respiratory failure.
These gains are even more notable when considering the increasing complexity and acuity of hospitalized surgical patients, many of whom represent some of the most medically vulnerable populations due to a national shift toward outpatient surgical models. As less complex surgeries continue to migrate to ambulatory settings, hospitals are now seeing a growing concentration of high-risk patients who require more intensive surgical interventions and extended hospital stays.
Building on Past Progress
The latest findings build upon a foundation established by previous analyses. In 2023, AHA and Vizient released a collaborative report highlighting improvements in patient safety and quality of care during the first quarter of 2024, when compared with pre-COVID-19 performance benchmarks. That earlier report revealed that enhanced safety initiatives and care protocols implemented by hospitals between April 2023 and March 2024 led to the survival of approximately 200,000 patients who, by 2019 standards, might not have made it through hospitalization.
Now, the new report refines and extends those insights, zeroing in on the outcomes for hospitalized surgical patients — a patient cohort that continues to face unique and growing challenges in the evolving healthcare landscape.
A Transformative Period for Surgical Care
According to the latest data, hospitalized surgical patients in early 2024 were nearly 20% more likely to survive than expected based on their clinical severity, compared to similar patients in the last quarter of 2019. This figure is drawn from sophisticated risk-adjusted outcome modeling, which takes into account the growing complexity of patients being treated in inpatient surgical wards today.
In particular, hospitals were able to significantly reduce three high-risk postoperative complications:
- Hemorrhage rates fell by 22.6%
- Sepsis rates declined by 9.2%
- Respiratory failure incidents dropped by 18.9%
These improvements are a direct result of hospitals’ efforts to adopt evidence-based practices, improve interdisciplinary care coordination, and leverage advanced health information technologies such as real-time data analytics and predictive modeling. In addition, many hospitals have expanded their investments in clinical staff education, enhanced infection control practices, and established early warning systems for detecting patient deterioration.
Rick Pollack, President and CEO of the AHA, praised the dedication of healthcare professionals who have contributed to these outcomes. “The safety and quality improvements in surgical outcomes underscore the resilience and unwavering commitment of hospitals and health systems — and the millions of hospital team members across the country — to delivering better care to the patients and communities they serve,” Pollack stated. “While hospitals are proud of these efforts, we know there is always more work to do to deliver the highest quality care possible.”
David Levine, MD, Senior Vice President and Chief Medical Officer at Vizient, echoed that sentiment and emphasized the role of digital tools in the transformation. “These results reflect the extraordinary efforts by hospitals to adapt and elevate surgical care,” he said. “By leveraging advanced analytics and technology-driven insights, health systems are not only addressing the increasing complexity of inpatient surgical cases but are improving outcomes in meaningful, measurable ways.”
Complexity on the Rise: New Challenges Ahead
The improvements highlighted in the report are even more impressive when contextualized against the backdrop of increasing case complexity within inpatient surgical populations. Over the last five years, a growing number of low-risk procedures — such as orthopedic repairs, laparoscopic surgeries, and some oncologic interventions — have shifted to outpatient surgical centers. As a result, inpatient surgical units are now disproportionately serving patients with higher clinical risk, chronic disease burdens, or post-operative recovery complications.
This shift has driven up resource utilization, the need for ICU-level care, and extended hospital stays. The average length of stay (LOS) for surgical inpatients has increased by nearly one full day over the last five years, the report notes. This increase in LOS reflects not only greater acuity but also systemic barriers in post-acute care transitions, such as:
- Delays in discharge approvals by commercial payers
- Denials of coverage for medically necessary post-acute services like skilled nursing, inpatient rehabilitation, or home health care
These administrative hurdles have led to inefficiencies in patient throughput and increased pressure on hospital capacity, particularly in surgical departments with high turnover demands.
Sustaining Momentum and Overcoming Barriers
While the overall findings are cause for optimism, the report also includes a call to action. As patient complexity grows, hospitals will need to continue innovating and advocating for supportive policy reforms that ensure sustainable improvements in patient outcomes.
Key areas for ongoing attention include:
- Expanding care team models to include surgical navigators, clinical pharmacists, and nurse practitioners trained in post-surgical care
- Improving discharge planning workflows, particularly in partnership with payers, to reduce avoidable delays
- Enhancing preoperative risk assessment and prehabilitation protocols for high-risk surgical candidates
- Continuing investment in artificial intelligence (AI) and real-time data platforms to predict complications before they occur
Policy leaders are also being urged to address systemic inefficiencies that undermine patient recovery and inflate hospital costs. For example, denials of appropriate post-acute care coverage can result in longer hospital stays that not only compromise recovery timelines but also burden hospital finances and limit access for incoming patients.
A Path Forward
The AHA-Vizient report concludes by emphasizing that the gains made from 2019 to 2024 are not accidental but the result of sustained institutional commitment to continuous improvement in surgical safety and quality. As the health system continues to evolve, hospitals are proving capable of rising to the challenge — even under intense external pressures, from staffing shortages to evolving payer policies.
More than just numbers, the reductions in complications such as hemorrhage, sepsis, and respiratory failure mean tangible differences in the lives of patients and families. Fewer ICU admissions. Shorter recovery times. Better quality of life after discharge. These are the real-world outcomes that define the success of modern hospital-based surgical care.
As Pollack noted, “There is always more work to be done.” But for now, the data offers clear and measurable validation of the tireless efforts made by clinical teams, administrators, and system leaders to ensure surgical patients have the best chance at safe, high-quality recoveries.
