Results from a recent three-year national health care collaborative may give Loudoun residents who must visit the county’s only hospital a sense of comfort. Inova Loudoun Hospital was named a 2011 Top Performing Hospital in the Premier Healthcare Alliance’s QUEST collaborative.

A total of 157 hospitals throughout 31 states voluntarily participated in QUEST. As participants, they agreed to share data and use definite benchmarks to measure success. In all, the collaborative is believed to have saved 24,820 lives nationwide and reduced health care spending by at least $4.5 billion.

The benchmarks each hospital was challenged to meet or exceed include reducing mortality at least 18 percent; reducing the average cost of care to less than per discharge; reliably delivering all evidence-based care measures to patients in the areas of heart attack, heart failure, pneumonia and surgical care at least 84 percent of the time; improving the hospital experience so that patients favorably rate their stay and would recommend the facility to others; and eliminating preventable harm events.

All of the hospitals within the Inova Health System finished as top performers.

“Our challenge was to provide better care for individuals, improve our community’s health services and, ultimately, reduce health care costs,”  said Knox Singleton, CEO, Inova Health System. “Our vision for the future is to optimize the health and well-being of each individual we serve. We know that reducing errors and curbing excessive costs is part of achieving that vision. So we will continue to share our patient outcomes data and best practices with other health care organizations as part of our effort to lead the industry in world class care.”

Deneen Richmond, vice president of performance improvement for Inova Health System, pointed to the excellent cardiac care at Inova’s hospital as one of the ways it has set itself apart as a top performer.

She said the system has done an excellent job of collaborating not only within the walls of each hospital but also between hospitals and throughout the community so that when a patient comes to an Inova hospital with a cardiac issue, there is a system that goes into place immediately that everyone is aware of, which increases that patient’s chance of survival.

Richmond gave two examples of how the system has worked recently.

In one case, a 57-year-old man arrived arrived at Inova Fair Oaks complaining of chest pain, radiating arm pain and nausea. The patient received an EKG within two minutes of arriving, was transferred to Inova Fairfax’s Cardiac Cath Lab within 17 minutes and had a stent placed to open his coronary artery, which was 99 percent blocked, within 74 minutes of his initial arrival.

The national goal for getting an emergency room patient through such a surgery is 90 minutes from the time he or she arrives at the hospital.

In the other case, Deneen described a 51-year-old patient who arrived at Inova Alexandria with chest pain. The patient was determined to have an 100 percent coronary artery blockage, and a stent was placed within 30 minutes of that patient’s arrival.

“QUEST hospitals show what’s truly possible in healthcare,” said Susan DeVore, president and CEO of Premier. “Together they have proven that top performance can be achieved by any hospital, no matter where they are, what their patient mix or their reimbursement levels. QUEST is discovering the keys to providing the best quality care and teaching others how to replicate their accomplishments so that we don’t have pockets of excellence – we have system-wide excellence.”

Another area where the QUEST hospitals have shared information and helped each other improve is determining when a patient has septicemia.

According to Terry Andrus, president and CEO of East Alabama Medical Center, another top performing hospital, a 28-year-old female patient was brought unconscious to East Alabama on Christmas Eve, and because of the what the hospital has learned from its participation in QUEST, the staff recognized that she had septicemia right away and took action. She was released from the hospital four days later, whereas two years ago, if she had even survived, she would have had about a month-long hospital stay.

“QUEST creates new, higher targets that any hospital can strive for,” Andrus said. “Once we saw what could be achieved, we had a very systematic way to focus and work on performance improvement. All the QUEST measures are very clear, making it easier for us to articulate the vision of where we want to be, and get buy-in from doctors, nurses, administrators and our board. It’s crystallized our quality work and given us a clear path forward.”

Donna Isgett, senior vice president of corporate quality and safety for McLeod Regional Medical Center in South Carolina also praised her hospital’s work in the area of septicemia from things it has learned from the QUEST collaborative. She said that one of her coworkers was brought to McLeod one day and appeared to be dying. They immediately recognized her symptoms as those of septicemia, followed protocol, and the patient survived. Later, a nurse for McLeod was in another city and was taken to hospital not participating in QUEST. She died from septicemia in that hospital.

“QUEST gave us the ability to look at ourselves differently,” Isgett said. “When we just looked at our data we thought we were doing well, but when we compared to others we realized we weren’t among the best. For mortality, we talked to other top performers to learn how they tested, analyzed and measured their data to come up with better processes. We did something similar and have been able to replicate those high performance scores to save lives at McLeod. Now we are sharing our own learnings and best practices with others.”

Premier estimates that if all hospitals in the country were achieving the goals QUEST’s top performers are achieving, about 87,250 lives and $34 billion dollars could be saved each year.

Although QUEST’s original three years are over, Premier has decided to continue the collaborative, setting even higher goals for the member hospitals and adding re-admissions as a new measure it will study. The original five measures were evidence-based care, cost of care, mortality, harm and patient experience.

For more information on QUEST, log on to http://www.premierinc.com.