By Dena Bunis, CQ HealthBeat Managing Editor
November 22, 2010 -- The Premier health care alliance, QUEST, a national collaborative of 157 hospitals working to improve quality and save money, reported that it has saved 22,164 lives and $2.13 billion over the first two years of the three-year project. The group says that if all the nation’s hospitals could replicate such results, another 64,000 lives and $23 billion could be saved each year.
"QUEST hospitals have volunteered to be a test bed for what’s possible in terms of performance improvement. These hospitals are setting new standards of excellence based on real-world experiences," Premier's president and CEO, Susan DeVore, said. "There is a national imperative to bend the health care cost curve while we continue to improve clinical quality. The hospitals in QUEST are achieving these goals. This effort testifies to the power of collaboration."
QUEST is a voluntary project that includes urban and rural, large and small, and teaching and non-teaching facilities from 34 states, including many hospitals that care for the poor and uninsured.
Using the nation's largest comparative database from Premier, QUEST participants and the Institute for Healthcare Improvement (IHI) identified the main drivers that lead to deaths, errors and excessive costs, as well as what would improve a patient’s experience in the hospital. Hospitals in QUEST are targeting those areas for improvement and are comparing themselves against one another and sharing what works best.
According to QUEST officials, when measured against Medicare data, QUEST participants had mortality rates 5 percent lower than non-participating facilities. And while inpatient care costs nationally have increased by 14 percent during the first two years of the project, the increase was just 2 percent among QUEST hospitals. In evidence-based care, QUEST participants have continued to improve performance and outperform peers by 1.5 percent, according to Hospital Compare data.
QUEST officials believe their data analysis has yielded results that could be applied nationwide. Their findings show:
- Variation between the top- and bottom-performing hospitals has narrowed over time as all hospitals have improved, proving, they say, that the QUEST model can work in any hospital, regardless of size, teaching status, safety net status or geography.
- Mortality rates among QUEST participants declined 23 percent since the baseline, with a large gain in the area of sepsis. Other conditions that drove the mortality gains included prevention of respiratory infections and cardiac care improvements.
- In the first two years, the biggest areas to bend the health care cost curve were increased labor productivity and elimination of supply costs. However, different types of hospitals bent the curve at different rates, with small teaching hospitals making the most significant gains, followed by large non-teaching and large teaching facilities.
Going forward, the next generation of QUEST—QUEST 2.0—will add more measures and clinical conditions that track with the goals of the new health care law, officials said. These include readmissions and health measures for diabetes, obesity, mental health problems and heart failure.
QUEST says it will also look more closely at cost trends to assess why some hospitals have been so successful in controlling costs relative to others. And the collaborative plans to analyze focused clinical interventions to determine which drove the greatest levels of improvement in areas such as pneumococcal vaccination and harm prevention.
