by Michael Parchman, MD, MPH, Director, The MacColl Center for Health Care Innovation, Kaiser Permanente Washington Health Research Institute
“Low-value health care” is a term that’s subject to many interpretations, but we define it as health care for which the potential for harm exceeds the possible benefit. Examples include:
Low-value care not only increases overall health care costs, but can also cause patient harm. Reducing this type of care requires that health care organizations engage providers and teams in the challenging work of sustained cultural, organizational, and behavior change.
We created and are testing the Taking Action on Overuse framework to help organizations change the culture of how medicine is practiced by engaging providers and teams to actively reduce low-value care. The framework identifies evidence-based strategies for obtaining buy-in, motivating behavior changes, and providing the necessary support and infrastructure for health care providers to engage and lead their peers in making changes that can improve the value of health care.
As we refine and develop the framework, we’re also building tools and resources from real-world lessons we’re learning from three partner health care organizations that represent different settings.
Our research of medical overuse-reduction efforts across the country has illuminated 3 common indicators of success that represent care teams taking ownership, including:
Taking Action on Overuse is an evolving framework for health care organizations to engage their care teams in reducing low-value, unnecessary care and to make those efforts last. It identifies evidence-based strategies for obtaining buy-in, motivating behavior change, and providing the necessary support and infrastructure for health care providers to engage and lead their peers in making the changes that improve the value of health care.
We know that culture change is hard. It’s challenging work. There are no easy answers, but we are beginning to learn HOW to engage in this important work. We invite you to share feedback about your experiences with reducing overuse and to keep up with our latest work by subscribing to the Taking Action on Overuse mailing list.
Dr. Michael Parchman directs The MacColl Center for Health Care Innovation at Kaiser Permanente Washington Health Research Institute. His research focuses largely on improving chronic illness care in primary care clinics by approaching them as complex adaptive systems. A family medicine physician, Dr. Parchman previously served the Agency for Healthcare Research and Quality as the director of Practice-Based Research Network Initiative and senior advisor for primary care. He has a joint appointment at the Department of Family Medicine and the Department of Health Services Research at the University of Washington and is a collaborator in their Institute of Translational Health Science.
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