One of the nation’s leading collaborative quality and efficiency improvement programs, the QUEST program sponsored by the Charlotte-based Premier healthcare alliance, offered up voluminous testimony as to its effectiveness on March 19, as Premier leaders gathered in Washington, D.C. unveiled the latest results from the program, which they said confirmed the value of data-driven, mission-focused healthcare delivery reform taking place in patient care organizations nationwide.
Indeed, the marquee data points that Premier senior executives, including president and CEO Susan DeVore and senior vice president-public affairs Blair Childs, noted, were these: had every U.S. hospital participated in this program, 950,000 lives and about $93 billion could have been saved over the past five years. As it is, the 333 U.S. hospitals currently participating in the QUEST program (QUEST began with 157 participant organizations in 2008) have saved 92,000 lives and $9.1 billion over the past five years, reduced central line bloodstream infections by 59 percent, and falls and pressure ulcers by 64 percent, as they’ve shared data across a broad set of clinical outcomes and cost-of-care measures, all aimed at the following goals:
> Reducing patient mortality by at least 31 percent
> Reducing the average cost of care to less than $5,690 per discharge
> Reliability delivering care to patients across evidence-based care measures in the areas of heart attack, heart failure, pneumonia, and surgical care at least 95 percent of the time
> Improving the hospital experience so that patients would rate their stays favorably and would recommend a facility to others at least 73 percent of the time
> Reducing preventable harm events
> Reducing readmissions by 12 percent
Praise from Donald Berwick, M.D.
Donald Berwick, M.D., a healthcare leader who was best known as CEO of the Cambridge, Mass.-based Institute for Healthcare Improvement (IHI) before serving as acting administrator of the federal centers for Medicare & Medicaid Services in 2010-2011, was on hand to praise the work of the QUEST program and to offer his perspectives on its contributions to healthcare delivery reform.
“I think QUEST is undoubtedly a breakthrough” for healthcare delivery improvement in this country, Berwick told the assembled members of the press. “It’s a breakthrough first for American hospital care, given how unexpectedly good the results are. And, given what Susan [DeVore] has indicated about expanding the project out to the continuum of care, it could be a breakthrough for all of American healthcare,” Berwick said. “By focusing on systems and processes, QUEST focuses on very important elements of care design and delivery, evidence and patient engagement. It does connect the best of clinical and delivery science with the best of healthcare delivery,” he said, emphasizing that “The alternative to the design-and-redesign approach” to care delivery and operational improvement exemplified by QUEST “is not a good one, and that is, just cutting and cutting and cutting, while relying on current processes” in care delivery. But when the leaders of patient care organizations engage in intensive, data-driven, evidence-based process improvement, he said, real change takes place, with simultaneous improvement in clinical outcomes and lowering of operational costs. “In fact,” he said, “I believe this ought to be the approach for all of American healthcare. It’s a strain on hospitals, because, moving away from volume-based payment, more care will move out beyond the inpatient hospital,” he added. But the intention of Premier executives to push the QUEST program far out into outpatient care is both a necessary and a laudatory step, he said.
QUEST participating-hospital leaders speak
Premier’s DeVore and Childs, and Dr. Berwick, were joined in Tuesday’s live press conference at the Premier Washington, D.C. offices, and via phone link, by two senior executives of QUEST-participating hospital organizations, Tamera Parsons, vice president of quality and patient safety at Mountain States Health Alliance of Northeast Tennessee and Southwest Virginia (based in Johnson City, Tenn.), and Thomas Macaluso, M.D., chief quality officer at Memorial Healthcare System of South Broward, based in Hollywood, Fla.
In the press release announcing the QUEST results, Parsons was quoted as saying, “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.”
Macaluso, whose six-hospital system has been participating in QUEST since 2010, said, “I see the strength of the QUEST program really in three ways. First, I see it in the encouragement of executive sponsorship in these efforts to improve care and reduce cost. The second is the ability to share what I consider sophisticated comparative data, again to help drive change. We say [at our organization], if there’s no data, there’s no improvement. And QUEST is providing comparative data that’s helping us to drive change. And the third,” Macaluso said, “is the ability for us to collaborate with colleagues in other organizations to drive change and improve care. Our changes mirror those of others. Our hospitals have had achievement in evidence-based care, mortality, and harm events.”