U.S. spending on healthcare is snowballing. It is expected to reach around 20 percent of the GDP by 2026. Many national organizations such as the American Board of Internal Medicine and the American College of Physicians have launched various initiatives to ensure that patients receive high-quality care (on par with the escalating costs).
Put simply, high-value care can be defined as healthcare that balances benefits with costs and harms. High-value care focuses on reducing harm and improving patient outcomes.
Here are some examples of high-value care recommendations:
- Doctors in Sonoma, California and elsewhere treating patients with back pain must order an X-ray only after the first six weeks of treatment (only if necessary). Studies show that imaging within the first six weeks of the onset of back pain does not significantly improve outcomes or has any positive impact on how patients are treated. In many cases, it is not necessary and may even pose a radiation risk.
- Many doctors in Sonoma, California suggest their patients to get an electrocardiogram. The test is not necessary if the patient has a low risk of heart problems, or until symptoms of heart problems are present. Further, there is no evidence to suggest that screening improves outcomes.
- Patients who exhibit sinusitis symptoms for seven days must not be given antibiotics. Antibiotics can kill common bacteria such as Moraxella catarrhalis and Streptococcus pneumoniae that cause sinusitis; however, sinusitis can have other causes. Antibiotics can have side effects such as diarrhea. In most cases, sinusitis symptoms resolve on their own.
- Doctors should be careful not to leave or place urinary catheters for managing urinary incontinence or to monitor output for critically ill patients.
- Medications should be prescribed for stress ulcer prophylaxis to only those patients who are at high risk of GI complications.
- Doctors should avoid performing repetitive CBC and chemistry testing in the face of lab stability.
- When ordering continuous telemetry monitoring outside of the ICU, use a protocol that governs continuation.
- RBCs should be transfused for hematocrit thresholds and only when symptoms of stroke, heart failure, or active coronary disease are present.
Steps to Implementing a Successful High-Value Care Initiative
- Review hospital data to identify high-value care opportunities
- Assemble a team of professionals to remove communication barriers and engage stakeholders
- Design a sustainable, evidence-based solution
- Engage providers. Explain to them why change is important
- Set SMART goals. Select metrics to measure impact
Dr. Guy has been serving his community for almost two decades now. His pragmatic approach and empathy give him an edge over his peers. Dr. Guy is a dedicated professional. He does not mind going the extra mile, if required, to help his patients get their health back on track. To fix an appointment, call us at 707-938-1255.