2020 was a year like no other! Stryker is weathering the COVID-19 storm and continues to be well-positioned for the future. The pandemic’s impact was dramatic in the second quarter and continued thereafter, resulting in our first annual decline in revenue since going public in 1979. However, we did well in keeping our employees safe, serving our customers, and displaying strong financial discipline, including delivering a record year of cash flow. The halting of elective procedures in various geographies around the world was the primary cause for sales declines across multiple divisions and was most strongly felt in our hip, knee, instruments and endoscopy businesses. Our performance continued to outpace our competition but was below our normal expectations given the macroeconomic conditions.
Kevin A. Lobo
Chair and CEO
The importance of our mission was reinforced by the pandemic, and, in 2020, together with our customers, we were driven to make healthcare better. Many of our employees went to work on-site every day during the pandemic, to manufacture critical products or support our customers on the front lines of healthcare delivery. Our focus on safety remained a top priority, and in addition to effective COVID prevention measures, we had an excellent reduction in injury rates in our manufacturing facilities. We embraced flexible work practices and employee well-being, and will evolve our ways of working based on our learnings through this challenging time. We continue to be regarded as a great place to work and moved up three spots to #5 in Fortune’s World’s Best Workplaces list. We also received Great Place to Work awards around the world, including in Europe and Asia-Pacific countries. We are making strong progress on Diversity, Equity and Inclusion (DE&I) by empowering our Employee Resource Groups and focusing on inclusive management practices, including a novel, internally developed training program called Think Twice.
We had several changes to our Board of Directors this year. We welcomed new board members Lisa M. Skeete Tatum, Founder and CEO of Landit, Inc., and Dr. Giovanni Caforio, Chairman and CEO of Bristol Myers Squibb, and we look forward to their contributions. In addition, Roch Doliveux announced that after 10 years of dedicated service, he will not stand for re-election in May 2021. On our leadership team, Katherine Owen announced her retirement from the Vice President of Strategy and Investor Relations role in March, after 13 years of valued service.
The importance of our mission was reinforced by the pandemic, and, in 2020, together with our customers, we were driven to make healthcare better.
Largely due to the pandemic, our reported sales declined 3.6 percent, our reported net earnings decreased 23.2 percent, and our adjusted net earnings decreased 9.9 percent, while we delivered $3.3 billion of cash from operations which was a 50 percent increase from 2019. As a commitment to our shareholders and our long-term goals we continued to increase our dividend rate, including by 9.6 percent for the January 2021 payment.
A hallmark of our historic growth record is steady innovation and acquisitions. In November, we closed the largest acquisition in our company’s history, Wright Medical, a fast-growing leader in extremities that will bolster our existing Trauma & Extremities business. We also launched many exciting products, including a wireless Acute Care bed and new product offerings in Neurovascular, Spine and Foot and Ankle. We released updated hip software for our Mako SmartRobotics System, secured regulatory approval for Mako applications in China, Brazil and Russia, and in spite of the pandemic, installed a record number of Mako Systems.
We made significant progress in cost transformation and had a strong year in procurement and expansion of our finance shared services. We were challenged in the rollout of our enterprise resource planning (ERP) program, and we intend to resume this program once our operations are stabilized. We also took decisive action to curtail spending due to the pandemic, which contributed to our cash flow performance in the second half of the year.
We are working to improve healthcare responsibly and sustainably because we believe the health of the world is as important as the people who live in it. We hope you will find the first annual comprehensive report informative, as it outlines our progress and commitments in areas like DE&I and environmental impact, including a carbon-neutral goal for our facilities by 2030. We are committed to delivering positive results for our employees, customers, communities and the planet, and we will measure, monitor and report on our progress.
Reflecting on 2020, I am proud of the resiliency our teams displayed, their commitment to our mission and values and our ability to build new capabilities that will serve us well in the future. The Stryker spirit is alive and well, and our people and culture will continue to deliver strong performance in the years ahead.
The Stryker spirit is alive and well, and our people and culture will continue to deliver strong performance in the years ahead.