CHARLOTTE, N.C. & WASHINGTON -- (BUSINESS WIRE) -- Hospitals nationwide could save 950,000 lives and approximately $93 billion over five years by replicating practices achieved by a national performance improvement collaborative.
These findings are based on hospital results from members of the Premier healthcare alliance QUEST® collaborative. The 333 participating hospitals set aggressive goals for rapid and sustained improvement; achieving excellence on a number of transparent measures; benchmarking performance against one another; and sharing knowledge to test and then scale strategies that improve the quality, safety and cost effectiveness of care.
Since 2008, QUEST hospitals have used transparent and publicly available measures that show that they’ve avoided 92,000 deaths and saved $9.1 billion in costs – enough to pay the annual salaries of approximately 60,000 primary care physicians.
“Together we’re showing that there is room for improvement in any hospital, no matter who they are. We all must focus on consistently providing better care,” said Thomas Macaluso, MD, chief quality officer, Memorial Health System of South Broward, Fla. “We’re both learning from and teaching others how to achieve system-wide change that impacts quality, costs and one’s personal care experience.”
Most industries have standards of measurement that define and show how to reach and maintain top performance. Despite many well-intentioned efforts throughout the years, healthcare lags behind in this regard. QUEST has put in place a successful framework for quality improvement.
Together, QUEST hospitals volunteer to transparently share data across a consistent set of measures. Over time, they compare their performance to match or exceed the top 25 percent of hospitals in all categories except cost, which is set at the top tercile. To reach these new standards of top performance, hospitals were challenged to:
Tamera Parsons, vice president of Quality and Patient Safety, Mountain States Health Alliance of Northeast Tennessee and Southwest Virginia said, “Healthcare has big opportunities for improvement. And QUEST has shown that change is not only possible, it’s probable under the right conditions. By setting high standards, comparing performance to others, transparently sharing results and creating open forums for idea exchange, hospitals can test and scale improvements that benefit all and ultimately help transform our health system. Participating hospitals are passionate about designing powerful, innovative advances in healthcare.”
Once standards are set based on the data, QUEST hospitals test concepts of change, monitor progress to the goals and transparently share best practices with one another. Process maps, checklists, standing orders and other effective ideas are then collected and housed in a social networking community for all Premier member hospitals and health systems to access. This supports performance improvement efforts and the spreading of best practices nationwide through education, coaching, and face-to-face learning.
QUEST standards of top performance can be adopted by any hospital in the country, and have been tested by participants of various sizes, geographies and teaching status, including disproportionate share and safety net facilities. In following these standards, other hospitals should be able to replicate the results of QUEST participants, which are outpacing national averages.
When compared to what is expected, QUEST hospitals observed mortality is 10 percent lower than national averages. Primary ways these hospitals improved their mortality rates include:
Complementing efforts to lower mortality, costs, harm and readmissions, QUEST members provide all recommended evidence-based care measures at least 96 percent of the time, a 14 percent improvement since 2008. This equates to 80,128 additional people receiving evidence-based care – more than the number of hospitalized Americans that die each year as a result of preventable medical errors.
At the same time QUEST hospitals have been improving their overall quality standards, they have also reduced the mean cost per discharge by $1,110, primarily by reducing costs for both labor and supplies by focusing on resource utilization, improved workflows and eliminating waste. As a result, QUEST hospitals’ costs are 14 percent lower than national averages, and have remained flat for the last three quarters.
“Since fiscal year 2010, sequestration, loss of disproportionate share and bad debt payments, ongoing reductions to the market basket and productivity adjustments are projected to have a cumulative effect of reducing hospital payments by $250 billion over the next 10 years,” said Premier President and CEO Susan DeVore. “Given this reality, hospitals are proactively working to stay ahead of a challenging economic imperative, finding all the ways they can to drive savings while improving their quality, safety and outcomes. We hope this effort provides valuable information around the biggest opportunity areas, as well as effective tactics that will help hospitals better weather ongoing financial challenges.”
Patient experience scores among QUEST hospitals have increased by 3 percent and they maintain a 1 percent edge over non-participants. Their readmission rates have declined modestly, dropping by 4 percent, a somewhat predictable result given that many facilities have just begun to work on this issue.
Despite overall improvements, there are areas where more can be done to improve healthcare across QUEST hospitals, the Premier alliance and the nation. The collaborative is going a step further with the next generation of QUEST, which will launch in January 2014, to continue to drive improvement on inpatient metrics that align with value-based purchasing and payment reductions and penalties, and to begin to enhance improvement on ambulatory and community health based metrics that will further help providers move to new models for delivering care.
The collaborative, which represents almost every state, including all hospitals in the state of Hawaii, aligns closely with federal policies such as value-based purchasing and the Partnership for Patients effort, but it started well before those policies became reality. Working with Premier’s partner the Institute for Healthcare Improvement, QUEST has provided education and best practice sharing on various strategies for improving healthcare since 2008. In fact, a key way for QUEST members to enhance performance is to participate in short-term, rapid-cycle improvement education “Sprints” designed to drive and sustain change in specific indicators or processes of care.
To link providers with patient data, evidence-based best practices and one another, alliance members, including those in QUEST, use PremierConnect™, healthcare’s largest integrated technology platform and social networking community. Clinical and operational apps on the platform enable data-driven decisions that save lives, remove waste and help coordinate care delivery.
About the Premier healthcare alliance, Malcolm Baldrige National Quality Award recipient
Premier is the nation’s largest performance improvement alliance of more than 2,800 U.S. hospitals and 90,000 other sites using the power of collaboration and technology to lead the transformation to coordinated, high-quality, cost-effective care. Owned by healthcare providers, Premier operates a leading purchasing network with nearly $5 billion in annual savings. Premier also maintains clinical, financial and outcomes databases based on 1 in every 4 patient discharges. A world leader in measurably improving patient care, Premier has the largest performance improvement collaboratives in America, including one in partnership with the Centers for Medicare & Medicaid Services. Headquartered in Charlotte, N.C., Premier also has an office in Washington. http://www.premierinc.com. Stay connected with Premier on Facebook, Twitter and YouTube.