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Berwick: Quest Program Results 'A Breakthrough'

Cheryl Clark, for HealthLeaders Media, March 20, 2013

But in its 29-page progress report, Premier said that problems and challenges remain:

"Despite overall improvements, there are measures where more can be done in the area of harm. For instance, QUEST hospitals still experience variation and opportunities to eliminate harm in discrete areas such as hospital-acquired c. difficile, surgical site infections, third- or fourth-degree perineal laceration and post-op respiratory failure."

Additionally, it said, that that Quest participating hospitals only "slightly" outperform other hospitals in patient experience scores.

Even though they've overall improved by 3% since the baseline, "and maintain a 1% edge over non-participants," largely through improved nursing and medication communication strategies, "significant opportunities for improvement remain in the areas of pain management and responsiveness of hospital staff."

Another area that could see better improvement is in 30-day readmissions, where Premier says "significant opportunities remain" in the area of heart failure, chronic obstructive pulmonary disease, septicemia, renal failure, digestive disorders, antepartum diagnoses and pneumonia."

Thomas Macaluso, MD, chief quality officer for Memorial Healthcare System of South Broward, Fla., said the six-hospital public healthcare system in South Broward has been participating in Quest since 2010, with very positive results.

For example, he said, by creating dedicated heart failure units within the hospital, they've been able to standardize handoffs and assure multi-disciplinary rounding.

In a statement, Premier's DeVore says hospitals across the country should pay attention, because all of them need to reduce costs.

"Since fiscal year 2010, sequestration, loss of disproportionate share and bad debt payments, ongoing reductions to the market basket and productivity adjustments are projected to have a cumulative effect of reducing hospital payments by $250 billion over the next 10 years."

She added: "We hope this effort provides valuable information around the biggest opportunity areas, as well as effective tactics that will help hospitals better weather ongoing financial challenges."


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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