WIHI - A Podcast from the Institute for Healthcare Improvement
Health & Fitness:Medicine
Date: January 13, 2011
Featuring:
Here’s something most clinical and quality leaders agree with: a lot of specialty care isn’t always necessary or beneficial. What’s more, there’s tremendous variation across the US in the use of specialist services — variation that tends to be driven by the volume of what’s available, not the health needs of a community’s residents.
Meanwhile, in the trenches of decision making and with state-of-the-art interventions available to diagnose and treat diseases of all sorts, doctors and patients want what’s best, and potentially lifesaving. We applaud the oncologist who’s carefully helping a patient with cancer weigh treatment options; we respect the cardiologist who’s prescribing someone who’s had a heart attack the best medications to prevent a recurrence; we want the C-section for the pregnant woman who might lose her baby otherwise.
It’s in this context that Doctors Neil Baker and Lawrence Shapiro and others are hard at work creating a framework to help providers get closer to an appropriate use of specialty services — to reduce unnecessary health care costs and to deliver better care to patients. Neil Baker is the co-author of a 2010 IHI white paper, Reducing Costs Through the Appropriate Use of Specialty Services, that lays out a six-step process for generating good data about current practice patterns, analyzing the information, and making agreed-upon changes.
In this model, physicians (including those making referrals to specialists) are partners and problem solvers in their areas of expertise, not passive recipients of external rules. Just ask Lawrence Shapiro. The work that’s been underway at the Palo Alto Medical Foundation in California is case in point of what’s possible.
Improving when, why, and how specialty care is tapped also intersects with robust work going on across the country, and globally, with shared decision making — where patients, too, better understand their options and the benefits, or not, of obtaining specialty care. WIHI host Madge Kaplan delves into a topic that is not rocket science in terms of solutions, but deserves plenty of attention and requires the best minds, and experiences on the ground, in order to make the right kinds of changes.
WIHI: Harnessing Improvement to Reduce Diagnostic Errors and Delays
WIHI: Medicare Reimbursement and Meaningful Conversations about End-of-Life Care
WIHI: Accelerating Improvement: The Enduring Value of Collaboratives
WIHI: How Health Care Organizations Can Create Equity in the Community
WIHI: Relationships Count: Community Health Workers and Team-Based Care
WIHI: Getting Right Care, Right!
WIHI: What Students in the Health Professions Can Do for You... and Improvement
WIHI: Saving Lives by Design: Lessons for All from Ghana's Project Fives Alive!
WIHI: The Echo Effect of Project ECHO's Access to Specialty Care
WIHI: The IHI Triple Aim: Lessons from the First Seven Years
WIHI: Disability Competent Care
WIHI: Now What? Best Practices for Newly Diagnosed Cancer Patients
WIHI: Leaning In: Oregon's Coordinated Care Organizations
WIHI: Reducing Risks and Defects with Help from the Front Lines
WIHI: All Hands on Deck to Reduce C. Difficile
WIHI: The Managers and Management We Need to Improve Care
WIHI: Bundles and Buy-In for Value-Based Care
WIHI: Topping the Charts in Pediatrics and Adverse Events Reporting
WIHI: The Ups and Downs of Health Care Costs and Reform
WIHI: When Everyone Knows Your Name: Identifying Patients with Complex Needs
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