ISSN : 2642-0007
Published by: Massachusetts Medical Society (10.1056)
Total articles ≅ 168
Latest articles in this journal
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0405
NEJM Catalyst Insights Council members comment on the findings of a home-based care survey.
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0400
An NEJM Catalyst Insights Council survey on home-based care finds broad demand for a range of home-based services. More integration with primary care is needed. Now including global data.
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0280
Leaders at the Hospital for Special Surgery (HSS) in New York, New York, have developed a framework to enhance and expand the use of both general and condition-specific patient- reported outcome measures (PROMs). Over the past 3 years, they have built 28 different PROMs into the electronic health record system and developed clinical decision-making tools. This effort, detailed in this article, addresses industry-wide developments and limitations and outlines how HSS has incorporated solutions to support patient engagement, clinical care, health care research, and quality-driven activities. The authors address the costs of customized programs and the nationwide challenges that impede widespread adoption of PROMs and offer a way forward.
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0190
Initiatives aimed at optimizing value and decreasing waste are traditionally carried out at a system level. Consequently, physician involvement may not be a key driver of the process, which can affect project outcomes and sustainability. To improve physician alignment with systemwide goals and create a culture of accountability, leaders at Riley Hospital for Children at Indiana University Health engaged medical directors by requiring them to carry out at least one clinical effectiveness project a year and present at one of the monthly meetings. The new position of medical director of clinical effectiveness helps oversee this. Within the first year, 26 new clinical effectiveness projects were started, and 75% of medical directors identified a project. This led to an estimated savings or revenue generation of more than $3 million. Another 25 projects were started during the second year, with an additional estimated savings or revenue generation of more than $13 million.
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0075
Leaders at Meritus Health in Maryland set out to devise a framework to ensure a connection between the aspirational goals that health care organizations envision and the day-to-day efforts that contribute to and support those goals through a tight alignment of the long-term strategic mission and the short-term tactical initiatives needed to get there. The program features a 10-year plan with four bold goals tied to the Quadruple Aim that is supported with measurable annual goals that are linked to each of the four aims and tracked as part of a 3-year strategic plan that can be adjusted as needed. The model features True North metrics and robust process improvement elements that can be adopted — and adapted — by others. Entering its second year, the effort has yielded both early successes and misses that can be addressed.
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0368
This issue of NEJM Catalyst Innovations in Care Delivery features solutions to chronic disease treatment, continuous quality improvement, the high cost of care, organizational strategy and alignment, patient-centered metrics, at-home patient care, and quality and outcomes measures.
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0371
NEJM Catalyst Insights Council members comment on the findings of a quality and outcomes measures survey.
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0203
The Consortium for Southeast Healthcare Quality (COSEHQ) created QualityImpact, a data-driven clinician performance improvement initiative for managing cardiovascular conditions, and scaled it across the Southeast United States between 2016 and 2019. Under the U.S. Centers for Medicare & Medicaid Services Transforming Clinical Practice Initiative, COSEHQ implemented the model in 735 clinical practices and engaged 4,692 clinicians. The initiative, which was intended to prepare clinicians for value-based alternative payment models, encompassed data transparency, professional education, evidence-based best practices, and peer-to-peer best collaborative learning. Clinicians received assistance with workflow optimization, care management, patient engagement, risk stratification, and revenue enhancement. At completion, 157,215 patients diagnosed with hypertension, diabetes, and other cardiovascular conditions showed clinical improvement. QualityImpact also led to reductions in the number of all-cause hospital and ED visits and achieved estimated cost savings of almost $200 million.
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0248
Leaders at the University of Utah Health Huntsman Cancer Institute have developed a hospital at home model for oncology patients that features ongoing monitoring and rapid response for patients with unstable, acute illness. Nurse practitioners, home health registered nurses, and other staff provide hospital-level care in the patient’s own home. Services are available within 2 hours of the patient arriving home and in response to emergent calls. Early results show reductions in hospitalizations, hospital length of stay, ED use, and cost of care.
NEJM Catalyst, Volume 2; https://doi.org/10.1056/cat.21.0370
Measuring quality and outcomes and converting measures to improvement remain challenging for a large majority of health care delivery organizations, according to an NEJM Catalyst Insights Council survey. Now including global data.