The Premier healthcare alliance announced this week that its QUEST: High Performing Hospitals collaborative has expanded from 157 charter members to include 293 hospitals across 40 states -- an 87 percent increase in participation.

Together, these hospitals share and compare information, working to improve their performance and strive for the highest standards of care. In just three years, QUEST charter member hospitals prevented 24,820 deaths and reduced healthcare spending by nearly $4.5 billion. Premier officials said. They did this by transparently analyzing their mortality, cost, evidence-based care, patient experience and harm performance to identify and implement opportunities for improvement.

[See also: Premier comparative effectiveness program seeking applicants.]

Building on QUEST’s success in the first three years, the next generation of QUEST – called QUEST 2.0 – has raised nearly all standards for top performance, according to Premier officials. These include:

• Mortality reduction goals from 18 percent to 24 percent;
• Cost of care goals from $5,720 per discharge to $5,690; and
• Evidence-based care goals from 84 percent to 95 percent.

QUEST 2.0 hospitals will also continue to work to improve the patient experience, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, and eliminate preventable harm events, officials said.

These new challenges align closely with the goals of health reform, including the implementation of a national value-based purchasing program; efforts to reduce readmissions; and infection prevention efforts, such as future payment penalties and the national Partnership for Patients initiative.

“Close alignment with health reform legislation should help QUEST members better prepare for the challenges ahead, including future policies and payment cuts,” said Susan DeVore, Premier's president and CEO. “These are practices that can be adopted by any hospital in the nation seeking to make systemwide improvements by comparing their performance with a higher standard of care.”

The QUEST hospitals have most recently been challenged to measure and improve performance in a new focus area: readmissions. The goal is to reduce their all-cause 30-day readmission rates to just 8 percent. National estimates suggest that most hospitals have readmission rates ranging from 18 to 25 percent, depending on the clinical condition.

To achieve successes, QUEST participants have established mini-collaboratives to improve their rates, such as one that focuses on reducing readmissions by optimizing discharge instructions.

QUEST hospitals also participate in so-called "sprints,” officials said, which provide opportunities to collaboratively share process improvement recommendations, and access technologies and lessons learned to quickly understand what works and what doesn’t.

This year, the sprints are very focused on improving patient safety by preventing incidents of harm, such as healthcare-acquired infections and pressure ulcers. There are also several sprints to improve the patient experience and reduce mortality.

[See also: What makes a high performing hospital? Ask Premier.]

Additionally, members participate on educational calls and webinars, access toolkits, meet face-to-face and are counseled by national healthcare experts to further guide improvement efforts.

At the end of the project’s first three years 120 QUEST hospitals achieved top performance standards. Their accomplishments directly led to patient care improvements and other quality gains.

According to Premier, QUEST includes a nationwide sample of urban/rural, large/small, teaching/non-teaching and safety net hospitals. Their advances are far outpacing current industry trends and national averages. If all hospitals in the country were able to achieve results like QUEST hospitals, Premier estimates that an additional 87,250 lives and $34 billion more could be saved across all payers each year. These are savings that hospitals can use to reinvest in care improvements for their local communities.