At a time when surgical complications were unchanged at most U.S.
hospitals, 16 Michigan hospitals pooled data and shared information about
factors critical to patient safety resulting in nearly 10% fewer surgical
complications, according to a University of Michigan Health System press
All the hospitals seeing these improvements participated in the health
system’s Michigan Surgical Quality Collaborative.
The reduction in surgical complications that program participants saw
represented cost-savings in several areas, including savings of up to almost
$13 million a year alone by avoiding ventilator-associated pneumonias in the
300,000 patients studied.
“The collaboration of hospitals in terms of identifying and
disseminating information about best practices is actually a much more
effective way of improving quality than just relying on each hospital alone to
come up with what they think is a way to improve quality,” study author
Darrell A. Campbell Jr., MD, a professor of surgery and chief medical officer
at the University of Michigan Health System, stated in the release. “In
other words, sharing ideas is important and it’s effective.”
Paid to participate
The backbone of the partnership is support by Blue Cross Blue Shield
(BCBS) of Michigan and its Blue Care Network, which pays hospitals to
participate and covers the cost of the technology needed to evaluate the data.
Hospitals then agree to share information, but individual hospital results are
not reported to BCBS.
The arrangement, called pay for participation, inspires collaboration
beyond competition, Campbell noted in the release. Because the concept is not
based on results, “we think this fosters a less competitive
atmosphere,” he stated in the release.
Campbell and his colleagues included general and vascular surgery cases
that were scheduled or done in emergency between 2005 and 2007. The results
showed the greatest improvements in rates of blood infection, septic shock,
prolonged ventilator use and cardiac arrest. Death rates remained unchanged.
Resource utilization changes
Campbell noted the potential cost savings when surgical complications
“Once something bad happens following surgery, it takes a lot of
resources for the patient to recover,” Campbell stated in the release.
The investigators calculated that a 1.8% reduction in surgical
complications per year for 3 consecutive years would offset the costs of
involvement in the pay-for-participation program.
“If this system was adopted nationally, not just in Michigan, I
think you would find a greatly accelerated pace of surgical quality
improvement,” Campbell stated in the release.