Hospitals participating in the first year of the Premier healthcare alliance's national collaborative, QUEST: High Performance Hospitals, saved an estimate 8,043 lives and $577 million by focusing on areas to improve healthcare, according to study results released this week.
At the beginning of QUEST, which stands for Quality, Efficiency, Safety, and Transparency, 157 hospitals voluntarily came together for this three-year project to basically try "to answer the very difficult questions: How do you simultaneously improve cost, quality, mortality, harm, and patient satisfaction at the same time," said Susan DeVore, Premier's president and CEO, at a Washington, DC conference unveiling the results.
"This group of hospitals did agree to be transparent with each other," she said. "They shared all of their data—good, bad, and otherwise. They talked about what their best practices were, and they worked together to really figure out how we were going to measure this, how we were going to automate this, and how we were actually going to improve this."
Premier, an alliance of nonprofit hospitals, learned from an earlier initiative with the Centers for Medicare and Medicaid Services (CMS) that looked at how to improve the implementation of evidence-based care. "We had huge success in that demonstration, but what our hospitals said to us is we've to get to systematic outcome measures. We've got to be ready for reform in whatever form it takes," DeVore said.
QUEST had 157 hospitals initially participating; another 31 were added later. They were from all over country and represented 31 states and all types of hospitals—big, small, urban, rural, teaching, and nonteaching, DeVore said. Healthcare reform means being "informed about what works. So what we're really doing is testing what might work—what might move the mark, what doesn't move the mark."
Working with the Institute for Healthcare Improvement, QUEST was used to help move hospitals to new levels of performance. Data from Premier's clinical database was used to determine the "baseline" level of performance for the areas of cost, mortality, and evidence-based care delivery. The hospitals then were challenged to find ways, by sharing data, on how to overcome main factors that lead to deaths, errors, errors, and excessive costs—while measuring themselves against one another.
Overall, in the first year, the QUEST hospitals reduced the cost of care by an average of $343 per patient and increased the delivery of recommended patient care measures by 8.74% and increased delivery of every recommended evidence-based care measure to an average 86.3% of the time. In addition, the hospitals reached a 14% reduction in observed mortality (compared to what was expected).