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Alvorada Hospital Case Study


Hospital Alvorada is a general hospital located in São Paulo, Brazil that was founded in 1961 as a small clinic with limited services. Over the past 56 years Alvorada has undergone several renovations to expand its physical facilities and medical services to serve the diverse population of São Paulo.

While Hospital Alvorada had established a solid reputation as a good general hospital in São Paulo within the AMIL network, Alvorada’s leadership wanted to differentiate itself within the healthcare market of not just Sao Paulo, but also all of Brazil and Latin America.

Hospital Alvorada approached HSS in 2014 to become an orthopedic center of excellence. HSS and Hospital Alvorada began a long-term collaboration that would transform Alvorada into a leading general hospital that is acknowledged throughout the region as a reference center in orthopedics.

Image: Alvorada Hospital exterior
Orthopedic staff
Surgeries per year


Learning from HSS was a paradigm shift in our culture. The partnership helped the hospital establish itself as a center of excellence in hip and knee arthroplasty in São Paulo and in Brazil.

Osvaldo Pires
Orthopedic Surgeon, Hospital Alvorada



Image: HSS Global Orthopedic Alliance Member badge

HSS transferred a holistic approach of patient care to Hospital Alvorada and its team. This involved not just the process of orthopedic surgery, but every step of a patient’s journey from entering the hospital for the first time to recording patient milestones months after any type of procedure is performed. Excellent patient care, research, and education are woven into the culture of the organization. These strategies have not just affected Alvorada’s orthopedic department, but also all functional areas of the institution.

HSS visited Alvorada once a year to evaluate progress and provide ongoing guidance on the path to orthopedic excellence. Areas of focus included orthopedic surgery, operational excellence, nursing, operating room efficiency, quality and patient safety, rehabilitation, and strategic guidance and leadership. HSS clinical pathways have been adapted to meet the needs of Alvorada’s environment in order to optimize the patient experience and efficiently expand its orthopedic volume. Team members from each area mentioned above have played a key role in the success of this multidisciplinary initiative.

Orthopedic surgeons, administrators, physical therapists, nurses, and other key team members visited HSS to see first-hand how we do what we do. They had the opportunity to have personal mentorship sessions and customized observerships. Alvorada’s team members also had ongoing communication and access to HSS mentors while in Brazil and used digital technology to participate in professional education programs held at HSS.

HSS created a Quality Fellowship that provided the opportunity for one quality specialist from Alvorada to spend time at HSS to learn about our quality management and patient safety initiatives. Key aspects of these programs were transferred to Alvorada. Alvorada’s surgical infection rate decreased and clinical protocols were established to maintain a high level of quality.

Additionally, HSS and Alvorada held an annual professional education program in Sao Paulo focused on orthopedic surgery and rehabilitation. Orthopedic professionals from around the region attended these programs, furthering Alvorada’s reputation as an Orthopedic Center of Excellence. HSS also assisted Alvorada in the development of a successful orthopedic fellowship program that attracts top trainees throughout Brazil.

Since 2014, Alvorada has optimized its quality and outcomes both clinically and operationally. Hospital Alvorada has put together a team within its organization to lead these efforts, and over the past few years has begun to collect the right data to make positive changes throughout the organization. Surgical volume and operational efficiency have increased concurrently, significantly improving the financial health of Alvorada.

Alvorada has made significant progress over the past two years, and has been recently designated as an HSS Global Orthopedic Alliance Member, and is well on its way to becoming an HSS Orthopedic Center of Excellence.

About Hospital Alvorada

Hospital Alvorada (HA) is a general hospital located in Sao Paulo, Brazil. In 2012 the hospital became a member of the United Health Group. All Brazilian hospitals in this group became known as Americas Medical Services in 2016.

Within the Americas Medical Services group, HA is the main provider of orthopedic care and has been accredited by JCI since 2012.

HA performs approximately 4,800 orthopedic surgeries each year and treats more than 12,000 patients per month in its emergency room. HA has 200 beds, of which 39 are in the ICU, for adults and pediatrics.

As part of its educational program, HA has residences in radiology and hand surgery and also offers a hip fellowship.

In 2016, Hospital Alvorada inaugurated its Center of Excellence which provides outpatient musculoskeletal services. Hospital Alvorada had a partnership with the Hospital for Special Surgery that began in 2014 and was a member of the Hospital for Special Surgery Global Orthopedic Alliance.


Key contact
Fernando Moises Pedro, MD, MBA, Technical Director,
+55 11 2186-9801

Hospital Alvorada logo



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