Skip to content Skip to navigation

Premier Shows Dramatic Quality and Cost Improvement Results with QUEST Initiative

November 30, 2010
by Mark Hagland
| Reprints
157 hospitals save 22,164 lives, $2.13 billion in 2 years

The marquee headline is enough to grab the attention of readers in and of itself: “157 hospitals in national collaborative save 22,164 lives, $2.13 billion over two years.” Then there’s the deck: “If all of the nation’s hospital’s could replicate these results, an additional 64,000 lives and $23 billion could be saved annually.”

But those are indeed the results being documented by the national collaborative called “QUEST: High Performing Hospitals,” an initiative being sponsored by the Charlotte-based Premier Healthcare Alliance. And in a telephonic press conference held Nov. 22, Premier leaders announced those results and more, to highlight the progress being made by hospitals nationwide involved in an initiative that they believe could be a model for healthcare reform as played out on the local-hospital level.

(For more information, see Premier’s press release on the subject.)

What’s more, QUEST hospitals’ observed mortality that has for the past two years been running at 5 percent lower than non-participant hospitals, when bench-marked against expected levels, while their cost trajectory is running at 2 percent inflation, compared to 14 percent industry-wide.

All these results led Premier leaders to hold their press conference last week to discuss their initiative’s results, and the implications for the industry as a whole.

Susan DeVore, Premier’s president and CEO, began by saying that she believes the results of the QUEST Initiative reflect “this approach to get at systemic, systematic performance improvement. The attempt is really to say, can we help hospitals, and can hospitals help themselves, to improve across all five dimensions at the same time? And if you could do that, wouldn’t that be a high-value, or a high-performing, healthcare system? So we really set out to define how you would measure those variables, and then define the metrics, and make improvements,” DeVore said.

“If you look first at mortality, we’ve seen a 23 percent reduction in observed mortality compared to what was expected,” DeVore continued. “You also see a declining mortality level [overall], and a decrease in variation in performance. So we feel very good about that. And if you compare the results of the QUEST hospitals to Premier hospitals not in QUEST, and to non-Premier hospitals, by the first quarter of 2008, you start to see a significant improvement in mortality levels, compared to the other groups.”

What’s more, as Premier officials noted, if one were to take the $603 per discharge saved by the participating QUEST hospitals, compared to non-QUEST hospitals, and multiply that figure by the number 37,526,480, which is the number of annual hospital discharges among all non-QUEST hospitals in the U.S., the total would come to $22.6 billion saved annually.

Referring to the presentation shared with the media at the press conference, DeVore said, “These to me are among the most compelling slides, because while we’re all working on quality, bending the cost of care remains a huge challenge. But the inpatient cost per discharge has gone from almost $5,900 per case to just over $5,200 per case, inflation-adjusted,” among QUEST hospitals, and, she said, “This is bending the cost curve,” particularly in the context of a nearly-14-percent increase in healthcare costs nationwide during the same two years. Clearly, she said, achieving a level of only 2 percent cost increases among QUEST hospitals during that time period is significant and noteworthy. And the cost savings, if achieved across the U.S. healthcare system, could among other things be applied to alleviating increasing shortages of physicians and nurses in patient care organizations nationwide.

Among the critical success factors that DeVore and her Premier colleagues cited with regard to the advances being made among QUEST hospitals included the following: executive leadership; staff engagement; the existence of an improvement framework, guided by multidisciplinary teams of leaders; the systemic use of data; the active use of some kind of learning system or community; and a workable framework for execution. As DeVore put it, “None of it matters if there isn’t a really strong execution framework to drive the change.