Hospitals that have been given incentives to collaborate with one another can significantly reduce surgical complications, according to a study conducted by the Michigan Surgical Quality Collaborative (MSQC)—a group hospitals throughout the state that joined to help improve surgical outcomes—and published in the Archives of Surgery.
The study was funded by Blue Cross Blue Shield of Michigan (BCBSM) and its Blue Care Network, which paid hospitals to pool and share patient data in hopes of utilizing the information to help lower adverse events related to surgery. BCBSM also covered technology costs related to data acquisition and analysis.
Information on general and vascular surgeries was collected between 2005 and 2007 at 16 Michigan hospitals, with the analysis finding that blood infections, septic shock, prolonged ventilation use, and cardiac arrest decreased approximately 10% among hospitals that shared data, versus the control group that did not collaborate with one another in which complications did not experience any measureable reduction.
According to study author Darrell A. Campbell, Jr., M.D., professor of surgery and CMO at the University of Michigan Health System, hospitals are making an effort to improve quality and cut costs across the board in the way they think is best, but this approach has met with only limited success.
"The collaboration of hospitals in terms of identifying and disseminating information about best practices is actually a much more effective way of improving quality," he says. "Our idea was to get a number of hospitals together so we could share and distribute information about best practices throughout a community of hospitals."
Campbell believes the results largely reflect the fact that data from the individual hospitals results is not reported to BCBSM, fostering a better environment for collaboration, even among competing hospitals. "The approach we’ve tried is called ‘pay for participation,’ rather than pay for performance," he says. "We think this fosters a less competitive atmosphere."
And while there are obvious benefits to patients if medical staffs are able to lower surgery complication risk factors, the study proved there are financial incentives as well, given that a complication can add weeks to a hospital stay and tens of thousands of dollars to the bill.
"Surgical complications are very expensive," Cambell says. "Once something bad happens following surgery, it takes a lot of resources to help the patient recover." Authors of the report estimated that by reducing complication by only 1.8 percent a year would offset costs incurred by a health plan to support a similar pay for participation program within three years.
Campbell went on to say that if projects like this were more widely adopted, surgical outcomes would accelerate across the board. "This is a system and approach the nation could take to improve quality. I hope that we are able to interest the government in adopting, or at least incentivizing, this approach in many different regions across the country."
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
