QUEST®: A Data-Driven Collaboration to Improve Quality, Efficiency, Safety, and Transparency in Acute Care

Area of Science:

• Health Services Research
• Quality Improvement Science
• Healthcare Management

Background:

• Premier, Inc. launched the Quality, Efficiency, and Safety with Transparency (QUEST®) collaborative in 2008.
• QUEST® is an acute healthcare program focused on enhancing quality and minimizing patient harm.
• The program engages member hospitals through coaching, sprints, minicollaboratives, and meetings.

Purpose of the Study:

• To evaluate the impact of the QUEST® collaborative on hospital performance metrics.
• To assess trends in cost, efficiency, evidence-based care, patient safety, and readmissions.
• To analyze the quantitative and qualitative outcomes of the QUEST® program.

Main Methods:

• Retrospective analysis of performance data from QUEST® hospitals (N=356) from Q3 2006 to Q3 2015.
• Utilized routine coaching, sprints, minicollaboratives, and face-to-face meetings for program engagement.
• Compared performance metrics including cost per discharge, evidence-based care adherence, mortality, safety harm, and readmissions.

Main Results:

• Adjusted cost per discharge decreased between Q3 2013 and Q3 2015.
• Adherence to evidence-based care improved from 77% in Q3 2006 to 95% in Q3 2015.
• Observed-to-expected mortality improved by 22%, safety harm scores moderately reduced, and readmission rates improved from 5% to 8% better-than-expected.

Conclusions:

• The QUEST® collaborative successfully reduced cost per discharge and improved adherence to evidence-based practices.
• Participating hospitals demonstrated reduced safety harm composite scores and improved patient experience.
• The program led to a reduction in unplanned readmissions among member hospitals between 2006 and 2015.