Premier Shows Dramatic Quality and Cost Improvement Results with QUEST Initiative

Maureen Bisognano, president and CEO of the Cambridge, Mass.-based Institute for Healthcare Improvement (IHI), an organization that has been in the forefront of advocating for improved patient safety and care quality in the past several years in U.S. healthcare, congratulated DeVore and her colleagues at Premier on the success of the QUEST initiative to date and emphasized the national implications of what’s been learned to date by the hospitals participating in QUEST. “This is a real demonstration that local change can happen that has national implications,” Bisognano said. “We’ve seen the debate over whether change can happen at the top and filter down, or whether it has to occur at the local level and bubble up.” It is actually important for change to be pushed from both directions, she emphasized.

In addition, Bisognano said, she sees three core success factors among hospital organizations that have made significant advances in patient safety, care quality, and efficiency in recent years. Those three elements, she said, are building the will to change across an organization; building new models for delivering care, and achieving “an exquisite execution focus.”

Significantly, Bisognano added, “I’m often asked by senior leadership teams, how am I doing? And most hospitals don’t have the level of benchmarking that QUEST has.” That element, she stressed, sets QUEST apart from many homegrown improvement efforts.

Asked about the importance of creating information technology and data reporting infrastructures to support all the data collection, data publishing, and data analysis elements in an initiative like QUEST, DeVore said, “We have small and large, and urban and rural hospitals, all participating. A lot of the measurements today come from the administrative data, and it’s a question of how you bring that into business intelligence; so most have the raw data to do this; the question is whether they can bring that raw data into business intelligence programs to make this work. A particular challenge is in the [patient] harm data [now being collected and reported by participating QUEST hospitals]. We have to make sure that what shows up in the administrative data is truly indicative of harm. There’s a similar issue on infections and automation.”

DeVore went on to say that “I think the part of the healthcare reform legislation and the HIT stimulus and meaningful use that is relevant here” is that federal policymakers, in drafting the comprehensive healthcare reform legislation passed in March, and the federal American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act, “are really moving hospitals towards accountability [for outcomes], which really encourages the integration of all this data.”

Not surprisingly, she added, the work being pursued within the QUEST initiative is “absolutely” complementary to the aims of healthcare reform and of the HITECH Act. “We also think this [work] allows you to focus in on the real drivers of harm, the real drivers of mortality. The challenge in terms of all the investment being made in IT now is, do you end up with a lot of unusable data, or can you turn the data into usable [performance improvement]?” To DeVore and her colleagues at Premier, the work being pursued under the QUEST banner answers that question perfectly.