Rural Hospital Receives QUEST High Performing Hospital Award

IUKA—The rural town may be small—some 3,000 residents live on the Tishomingo County site that once housed a Chickasaw Indian village and won first prize at the 1904 World’s Fair for the purest and best mineral water —yet North Mississippi Medical Center-Iuka (NMMC-Iuka) made national headlines when a national healthcare alliance presented hospital administrator Fred Truesdale an award received by only six hospitals in the United States—and the only one in Mississippi—for delivering high value healthcare.

NMMC-Iuka received the Premier healthcare alliance’s inaugural QUEST Award for High Value Healthcare for reaching the top performance thresholds by reducing harm, mortality and cost of care, while also increasing patient satisfaction and adherence to clinical evidence. More specifically, the hospital eliminated avoidable hospital deaths, safely reduced the cost of care for patient hospitalization, delivered the most reliable and effective care based on national guidelines with proven practices, improved patient safety by preventing harm in 25 categories including infections, and improved patients’ overall care experience.

“We’re determined to deliver the best care to our patients by operating in an environment with the safest, highest quality practices possible,” said Truesdale, when accepting the award at Premier’s annual Breakthroughs Conference and Expo in Nashville, Tenn., on June 15. “Patient-centeredness is our responsibility and we’re happy to accept this honor.”

From the fourth quarter of 2008 to the same time period in 2009, NMMC-Iuka improved the delivery of recommended evidence-based care measures by approximately 16 percent as a participant in the voluntary QUEST collaborative. Evidence-based care measures include interventions such as administering aspirin upon arrival and discharge and smoking cessation for heart attack patients. In doing so, NMMC-Iuka reduced its case mix and inflation adjusted cost by an average of $200 per patient while reducing harm in its organization through initiatives designed to prevent patient injury, such as fall and pressure ulcer prevention. Additionally, with targeted improvements, the hospital’s patient satisfaction scores have increased since joining QUEST.

“Cost and case mix were directly impacted by the addition of case management services and utilization of concurrent coding,” said Truesdale. “Safety measures were improved through quality initiatives such as a system-wide fall prevention program and pressure ulcer prevention campaigns.”

Charlotte, NC-based Premier, a performance improvement alliance of more than 2,500 U.S. hospitals and 75,000 additional healthcare sites, established the QUEST collaborative to lead the transformation to high quality, cost-effective care. Hospitals, health systems and other providers own Premier, which has worked with the Centers for Medicare and Medicaid Services and the United Kingdom’s National Health Service North West to improve hospital performance. It is recognized for maintaining the nation's most comprehensive repository of clinical, financial and outcomes information and operates a leading healthcare purchasing network.

In the first 30 months of the collaborative, QUEST hospitals saved an estimated 25,235 lives and $2.85 billion in costs. Their observed mortality is 5 percent lower than non-participants when compared to what is expected, having dropped 23 percent. Furthermore, national costs for inpatient care have increased by 21 percent over the course of the project, compared to a mere 4 percent cost increase among the QUEST hospitals.

An existing QUEST member, NMMC began including its community hospitals in 2009, when 185 facilities participated for the award. Today, 250 participants vie for top performance awards. Thresholds are established at the top quartile of performance from a baseline period in all measures except cost of care, which was based on the median of the total inpatient cost per case mix adjusted discharge. Top performance for each dimension varied depending on the unique measure calculation and methodology.

“NMMC-Iuka has been engaged in and dedicated to a nationwide improvement collaborative designed to achieve cost-effective, evidence-based care delivery, thereby improving outcomes, reducing mortality and harm and providing the best experience they can for their patients,” said Premier CEO Susan DeVore.

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