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Premier Healthcare Alliance Charts Nationwide Performance Gains

January 18, 2012
by Mark Hagland
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Groundbreaking improvements noted among QUEST Hospitals Nationwide

On Jan. 18 in Washington, D.C., executives and leaders of the Charlotte, N.C.-based Premier healthcare alliance held a live-plus-telephonic press briefing to announce three years of results from the organization’s ongoing QUEST High-Performing Hospitals Collaborative program and to showcase the comments of several senior executives from Premier member hospitals participating in the QUEST program.

In its announcement to the healthcare press the day before about the upcoming press conference, Premier’s media relations team offered the marquee headline results thus: “Join hospital and healthcare experts for a briefing on how 157 hospitals saved 25,000 lives and $4.5 billion in three years.”

And indeed, as Susan DeVore, Premier’s president and CEO, and Blair Childs, the alliance’s senior vice president of public affairs, noted at the outset of the press briefing, the results that the 157 member hospitals have been working to achieve in the past few years could indeed be industry-leading going forward.

“If you were to ask a healthcare payer what would constitute quality, they might say that [a hospital organization was] consistent, with good outcomes, etc. We decided to measure five elements at the same time”: improvements in the areas of patient mortality, avoidance of harm to patients, the use of evidence-based care processes, inpatient cost per case, and positive patient perception.

An accompanying press release noted that, “Spanning 31 states, QUEST includes a nationwide sample of urban/rural, large/small, teaching/non-teaching and safety net hospitals. Together, the hospitals volunteered to transparently share data and define a common framework with consistent measures of top performance—something that has never existed in healthcare. During QUEST’s first three years,” the press release noted, hospitals tracked and compared their performance levels to match or exceed the top 25 percent of hospitals in all categories except cost, which was set at the top 50 percent.”

The press release noted that, to reach those 25-percent quality and 50-percent cost standards, member hospitals had to:

  • Reduce mortality by at least 18 percent;
  • Reduce the average cost of care to less than $5,720 per discharge;
  • Reliably deliver all evidence-based care measures to patients in the areas of heart failure, pneumonia and surgical care at least 84 percent of the time;
  • Eliminate preventable harm events;
  • And improve the hospital experience so that patients favorably rate their stay and would recommend their facility to others.

Top-line results in the past three years include the following:

  • When compared with a national cohort of similar hospitals, the mortality rate among QUEST hospitals, after three years, was 29 percent lower than national averages, based on Medicare data from federal fiscal year 2009, the most recent available;
  • Meanwhile, data from the U.S. Bureau of Labor and Statistics suggests that QUEST hospital inpatient costs increased y only 2 percent above the rate of inflation over the years 2008-2010, while costs among non-participant hospitals increased by an average of 17 percent above inflation during the same time period.

Among numerous other results, the following occurred among QUEST hospitals during 2008-2010:

  • 6,092 sepsis deaths were averted;
  • 7,296 deaths related to respiratory conditions were prevented;
  • 3,838 deaths related to cardiac conditions and shock were averted.

Meanwhile, among QUEST-participating hospitals, there was a 73-percent point increase in hospitals meeting the top performance thresholds established by the program, from the baseline start in 2008 January through December 2010 data.

In order to ensure the accuracy of their analysis, Premier staff members engaged academic researchers from the Center for Quality of Care Research at Baystate Health, Springfield, Mass., to check their results.

In addition to the overview of QUEST program results that Premier’s DeVore and Childs presented, the press briefing included comments from three executives representing QUEST-participating hospitals, who not only presented statistical results showing their progress in the program, but who also added anecdotal stories that strongly enhanced the overall presentation. For example, Terry Andrus, president and CEO of East Alabama Medical Center of Opelika, Ala., related a story of a recent case in which a 28-year-old female patient who was discovered being medically unresponsive in her home was brought into the hospital, with clinicians immediately following the septicemia treatment protocol developed under the QUEST program to her care, and, Andrus noted, “Four days later, she was home. Two years ago, her likelihood of survival would have been pretty slim, because we wouldn’t have known the protocol,” Andrus commented. “And even if she had been, she would have been in the ICU a very long time, and it would have cost us upwards of $100,000 for her care.”

Even more dramatically, Donna Isgett, R.N., vice president of clinical effectiveness at McLeod Regional Medical Center in Florence, S.C., after relating a story similar to that of Andrus, added another one. “The irony,” she said, “is that the nurse who taught the sepsis protocol here was traveling in another city, and died of sepsis because that hospital didn’t know what to do” in terms of applying a protocol for ED care of major sepsis, as McLeod’s clinicians had been able to do. “This is real, human stuff,” Isgett emphasized. “It’s saving lives.”

The Premier Health Alliance website provides additional background on the QUEST program.