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: End-of-Life Care and How Communities Can Become "Conversation Ready"
WIHI: 10 Things Every Hospital Needs to Know to Be Safe
WIHI: The Road to Team-Based Primary Care and Behavioral Health
WIHI: 100 Million Healthier Lives by 2020
WIHI: Optimizing Safety with the Electronic Health Record: The Latest on Glitches and Fixes from the Frontlines
WIHI: Better Care and Better Value for Hip and Knee Replacement
WIHI: Mental Health Care in the Hospital: Preventing Harm, Promoting Safety
WIHI: From Here to CLER: Graduate Medical Education and the Clinical Learning Environment Review (CLER)
WIHI: Tread Water No More! Making Sense of Patient Experience Data
WIHI: Preventing Financial Harm to Patients: The Costs of Care Initiative
WIHI: From Prehospital to In-Hospital: The Continuum for Time-Sensitive Care
WIHI: New Roles, New Routes for Managing Populations
WIHI: Making the Work of QI Less Draining and More Sustaining
WIHI: The Patient-Centered Medical Home: Early Results, Tough Scrutiny
WIHI: Partnering with Patients for Safety: The Next Phase of Work and Commitment
WIHI: Transforming Tensions and Tempers on Health Care Teams
WIHI: Reclaiming Empathy — Best Practices for Engaging with Patients
WIHI: Bright Spots for Patients with Complex Needs
WIHI: How High? How Low? Shared Decision Making Amidst Shifting (Hypertension) Guidelines
WIHI: Mobilizing Skilled Nursing Facilities to Reduce Avoidable Rehospitalizations
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