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: Highly Reliable Hospitals: The Work Ahead
WIHI: The Patient Will See You Now: New Technology for New Collaborations
WIHI: The Social Imperative to Demonstrate That Better Care = Lower Costs
WIHI: Have You Had "The Conversation"? Helping Loved Ones Discuss End-of-Life Preferences
WIHI: Removing Barriers to Care with Medical-Legal Partnerships
WIHI: Heard at the Forum: New Ideas and Learning from IHI's 23rd Annual National Forum
WIHI: Night Talks and Nocturnists: New Interventions for the Hospital at Night
WIHI: Health Literacy: New Skills for Health Professionals
WIHI: Organizing for Health: A Story from South Carolina
WIHI: Safety Net Hospitals: Untold Stories of Quality Transformation
WIHI: Family Caregiving, Caregivers, and Compassion
WIHI: Managing Medication Shortage: Best Practices for a Crisis
WIHI: Always Events: Raising Expectations for Patient Experience
WIHI: Payment Reform As We Speak
WIHI: Improving Health Care: The Global View
WIHI: New Models for Patients with Multiple Health and Social Needs
WIHI: Integrity On and Off the Page: A Discussion with JAMA’s (Departing) Editor-in-Chief
WIHI: Leading Across the Continuum
WIHI: Palliative Care = Quality Care
WIHI: The Power to Detect and Improve: Revisiting the IHI Global Trigger Tool and Adverse Events
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