title: QUEST®: A Data-Driven Collaboration to Improve Quality, Efficiency, Safety, and Transparency in Acute Care.
abstract: BACKGROUND
  In 2008 Premier (Premier, Inc., Charlotte, North Carolina) began its Quality, Efficiency, and Safety with Transparency (QUEST®) collaborative, which is an acute health care organization program focused on improving quality and reducing patient harm.
  
  
  METHODS
  Retrospective performance data for QUEST hospitals were used to establish trends from the third quarter (Q3; July–September) of 2006 through Q3 2015. The study population included past and present members of the QUEST collaborative (N = 356), with each participating hospital considered a member. The QUEST program engages with member hospitals through a routine-coaching structure, sprints, minicollaboratives, and face-to-face meetings.
  
  
  RESULTS
  Cost and efficiency data showed reductions in adjusted cost per discharge for hospitals between Q3 2013 (mean, $8,296; median, $8,459) and Q3 2015 (mean, $8,217; median, $7,895). Evidence-based care (EBC) measures showed improvement from baseline (Q3 2006; mean, 77%; median, 79%) to Q3 2015 (mean, 95%; median, 96%). Observed-to-expected (O/E) mortality improved from 1% to 22% better-than-expected outcomes on average. The QUEST safety harm composite score showed moderate reduction from Q1 2009 to Q3 2015, as did the O/E readmission rates--from Q1 2010 to Q3 2015--with improvement from a 5% to an 8% better-than-expected score.
  
  
  CONCLUSIONS
  Quantitative and qualitative evaluation of QUEST collaborative hospitals indicated that for the 2006-2015 period, QUEST facilities reduced cost per discharge, improved adherence with evidence-based practice, reduced safety harm composite score, improved patient experience, and reduced unplanned readmissions.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Crimmins
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Lowe
authors.forename: Monica
authors.initials: M
authors.lastname: Barrington
authors.forename: Courtney
authors.initials: C
authors.lastname: Kaylor
authors.forename: Terri
authors.initials: T
authors.lastname: Phipps
authors.forename: Charlene
authors.initials: C
authors.lastname: Le-Roy
authors.forename: Tammy
authors.initials: T
authors.lastname: Brooks
authors.forename: Mashekia
authors.initials: M
authors.lastname: Jones
authors.forename: John
authors.initials: J
authors.lastname: Martin
mesh_terms: D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D061214:Patient Safety / Q000191:economics / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D015397:Program Evaluation; D058996:Quality Improvement; D014481:United States