Medical organizations are participating in a campaign to help clinicians and patients avoid wasteful and sometimes harmful medical interventions. Recently, experts in pediatric and adult health from diverse geographic locations of the United States and from a mix of academic and non- academic settings shared their experiences, consulted their colleagues, and analyzed numerous studies in the medical literature to determine the top recommendations for improving healthcare value. Following these recommendations, which are outlined in a new study published today in the Journal of Hospital Medicine, will lower costs and lead to better care for patients.
Experts estimate that waste constitutes up to 20% of health care expenditures in the United States. To address this problem a number of national medical societies have joined the Choosing Wisely® campaign, with each creating a list of five common but sometimes unnecessary, tests, therapies, or procedures in their fields that patients and physicians should question and discuss. The Society of Hospital Medicine joined this effort in 2012, and it asked experts to create such lists regarding the care provided to hospitalized adults and children.
In addition to including the Choosing Wisely lists for pediatric and adult hospitalists, the new articles provide details about the methodologies used to create them. The details can serve as a blueprint for other healthcare organizations interested in researching and developing lists of potentially over-used or harmful interventions.
The recommendations – five for hospitalists and five for pediatric hospitalists – were published jointly by the American Board of Internal Medicine Foundation and the Society of Hospital Medicine in early 2013.
The top five recommendations proposed for hospitalized children are:
"If pediatricians around the country adopt and follow these recommendations, the savings to our health care system could be in the millions, given the large number of hospitalized children this would affect," said lead researcher Ricardo Quinonez, MD, FAAP, FHM of the Children's Hospital of San Antonio and Baylor College of Medicine.
In an accompanying review, researchers also outlined the five recommendations adopted by the Society of Hospital Medicine regarding the care of adults. These recommendations include:
"These [pediatric and adult] lists are good starting points, and in fact many hospitalist groups, including our own, are using the Society of Hospital Medicine practices as a foundation for our waste reduction efforts," wrote Andrew Auerbach, MD, MPH, and Robert Wachter, MD, of the University of California, San Francsico, in an accompanying editorial. "The next challenge will be translating these recommendations into actionable measures and then clinical practice."
Through a grant from the American Board of Internal Medicine Foundation and supported by the Robert Wood Johnson Foundation, the Society of Hospital Medicine has already begun to promote the adoption of the recommendations for hospitalists and pediatric hospitalists. It will be educating hospitalists through a series of online webinars, presentations at regional meetings and a national competition to gather and promote the best case studies in implementing Choosing Wisely recommendations in hospitals. For more information, visit http://www.hospitalmedicine.org/choosingwisely.
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