Hospitals in Premier’s QUEST collaborative collectively avoided 136,375 deaths and saved about $11.65 billion over the past five and a half years using the alliance's methodology and integrated analytics.
Premier released the results in a call with media on Thursday.
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While national hospital costs have increased by 37 percent since 2008, costs for QUEST hospitals have only risen 14 percent and remained flat for the past year. This averages to an annual 2.3 percent year-over-year cost increase that is only 0.4 percent above the rate of inflation, suggesting that QUEST members are bending the cost curve in healthcare comparable to the rest of the economy, Premier executives note.
If all 5,700+ acute-care hospitals nationwide were able to achieve QUEST standards of performance, $21 billion could have been saved last year, they add.
In addition to lowering costs, QUEST members have made substantial gains in quality, including reducing their mortality rates 14 percentage points lower than a matched sample of hospitals not in QUEST. Of the deaths avoided, the largest improvements were made in sepsis, where 21 percent of all deaths prevented, according to Premier numbers and reductions of 6 percent each in stroke, heart failure and respiratory infections.
QUEST is a national quality improvement collaborative composed of 350 hospitals representing almost every state in the country, including all hospitals in Hawaii. Members are large and small, teaching and non-teaching, urban and rural, and high and low disproportionate share hospitals.
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"Too often, the healthcare debate centers around the policies needed to incent change," said Susan DeVore, Premier president and CEO, in announcing the QUEST hospital numbers. "But we have learned that change can be driven from the inside, using data to pinpoint opportunity areas, friendly competition to ‘race to the top,’ and a collaborative model for sharing best practices.
"QUEST members are setting new standards in healthcare quality, efficiency and safety," she added. "Their results show these efforts to improve do not require additional cost – they actually reduce costs and save lives. It is our hope that hospitals across the country will benchmark against and seek to beat the QUEST performance levels."
QUEST members rely on Premier's methodology to transparently share and compare their data, performance and experiences with one another. All measures used by the collaborative are publicly available and can be leveraged by any hospital to set quality improvement goals based on aggressive standards of top performance.
This collaborative approach to performance improvement has led to the identification and rapid adoption of best practices to reduce mortality and costs, and improve safety, patient experience, quality and the delivery of evidence-based care. According to Premier, these interventions were also successful in:
- Preventing 40,808 readmissions since 2011;
- Preventing 17,991 instances of harm, such as hospital-acquired infections, since 2010; and
- Providing approximately 109,851 additional patients with all appropriate, evidence-based care for all the clinical conditions assessed since 2008.
“QUEST accelerates quality and cost improvement efforts by creating an open forum to test ideas and scale positive change," Harold Berenzweig, MD, executive vice president at Texas Health Resources, a QUEST member in Arlington, Texas, said in a news release. "By comparing our data with others, we can clearly see where performance gaps may exist. We then work together to rethink the status quo way of providing care. In QUEST, we're transforming the delivery of healthcare in North Texas, one innovation at a time, to benefit all of our communities."
"Programs like QUEST help us change the game," said Nancy Carragee, vice president of quality improvement at Daughters of Charity Health System, in a statement. Daughters of Charity health System is a QUEST member in Los Altos Hills, Calif. It serves the sick and those living in poverty in communities from the San Francisco Bay Area to Los Angeles.
"We work as a team to create and sustain care delivery improvements to benefit our patients and show the industry what can be achieved," Carragee added. "With approaching payment cuts, marketplace changes and reforms that require taking on more risk, there couldn’t be a better time to be a part of a program like this."
QUEST members have also enhanced their performance through short-term, rapid-cycle educational "sprints," designed to drive and sustain improvement in specific processes of care. Through these efforts, Premier executives say they have reduced:
- Central line (central venous catheter) associated blood stream infections (CLABSI) rates by 82 percent;
- Injuries rates while in the hospital, including falls, by 71 percent;
- Pressure ulcers rates by 65 percent;
- Staph (septicemia) infection rates by 36 percent;
- Ventilator acquired pneumonia rates by 23 percent;
- Catheter-associated urinary tract infections (CAUTI) rates by 19 percent; and
- Birth trauma (perineal laceration) rates by 18 percent.
QUEST members use Premier’s integrated technology platform PremierConnect to standardize and share patient data, performance improvement analytics, and evidence-based best practices with one another. PremierConnect aggregates patient data on one in four U.S. hospital discharges, evidence-based best practices from 2.5 million daily clinical transactions, and approximately $40 billion in annual provider purchases. The platform enables providers to interact in real-time and ensure best practices are being implemented nationwide.
