Jan Mathews, director of clinical performance at Gaston Memorial Hospital in Gastonia, N.C., a suburb of Charlotte, says information technology has been essential to the hospital’s efforts to decrease overall morality rate from 2.75 percent in 2005 to 1.47 percent in 2009.

“In order to make changes in quality, you have to track concurrent data,” Mathews said.  “We know you cannot manage what you do not measure.”

The data is best tracked electronically, she said, Mathews calls it “moving the dot, referring to pushing the dots on a graph toward a goal also depicted on the graph.

The goal on this graph: to decrease the incidence of sepsis - a life-threatening condition caused by infection of the bloodstream. At Gaston Memorial Hospital, sepsis is the No. 1 cause of preventable mortality, Mathews said, Nationwide, sepsis is responsible for 90,000 deaths a year, Mathews spoke at a Jan. 6 online presentation that highlighted the efforts and gains of hospitals that are part of the Premier healthcare health alliance’s QUEST: High Performing Hospitals program.

The three-year program includes nearly 200 not-for profit hospitals of all types and sizes in 34 states across the country. The program, which includes rigorous measures, is designed to spur hospitals to new levels of performance. The goal is to save lives, improve care and safely reduce the cost for each patient’s hospitalization.
QUEST hospitals track five measures to help drive performance, said Richard Bankowitz, MD, Premier’s chief medical officer.

They are:

• Evidence-based care
• Mortality ratio
• Cost of care
• Harm avoidance
• Patient experience

The intent, said Bankowitz, is to boost performance – and save money – by “sharing knowledge and sharing data.”

QUEST released the results from the first year of the project last October. They showed that the original 157 hospitals that participated in the program saved an estimated 8,043 lives and $577 million in one year. Also, 24, 818 additional patients received the treatments that met the highest quality patient care standards when compared to the baseline performance at the beginning of the program.

To reduce mortality from sepsis, Gaston Memorial also employed automated alerts, software developed by Addison, Texas-based MEDHOST, a developer of emergency department technology. 

In the emergency department, it’s critical to get the antibiotics ordered and administered quickly, Mathews said. The alerts remind the clinicians.

“The longer you wait, the mortality for severe sepsis rises,” she said.

At North Side Hospital and Johnson City Specialty Hospital, part of the Mountain States Health Alliance, in Johnson City, Tenn, Gail Hicks, vice president and director of nursing, is tracking the five measures put forward by Premier and the Institute for Healthcare Improvement.

Mountain States Health Alliance encompasses 14 hospitals and spans 29 counties in a four-state region.
Among the strategies to reduce mortality at Mountain State the use of drill-down reports to find small windows of opportunity.

The mortality indices went from 1.54 for 2007 to 0.62 for the second quarter of 2009.
Small changes can make a big difference in better patient care and in bending the cost curve, according to Hicks.
Mathews agreed. “If you’re looking at value based health, you really have to look at the 360-degree view.