Engaging Physicians in Change: Results of a Safety Net Quality Improvement Program to Reduce Overuse
- 27 September 2010
- journal article
- other
- Published by Ovid Technologies (Wolters Kluwer Health) in American Journal of Medical Quality
- Vol. 26 (1), 26-33
- https://doi.org/10.1177/1062860610373380
Abstract
Identifying, understanding, and addressing clinical variation is a useful tool to promote appropriate care while helping control health care costs. Although accurate, relevant, and useful data are important in the process, successfully engaging physicians to change behavior is often the most significant challenge. Using a commercially available variation analysis process, a California Medicaid managed care plan identified significant network practice pattern variation. A team of panel practitioners then developed a strategy to reduce overuse of 5 identified behaviors. The intervention was evaluated using a pre—post comparison of the panel’s use of the 5 behaviors. During the preintervention period, narcotics, muscle relaxants, magnetic resonance imaging (MRI), and spinal injections increased between 8% and 18% per month. Postintervention, the trends reversed. The differences were statistically significant (P < .0001) for muscle relaxant use, narcotic use, overall MRI use, and spinal injections. Peer comparison data and respectful feedback was associated with significant change in patterns of overuse.Keywords
This publication has 10 references indexed in Scilit:
- Assessing the Appropriateness of Care—Its Time Has ComeJAMA, 2009
- Beyond Pay for Performance — Emerging Models of Provider-Payment ReformThe New England Journal of Medicine, 2008
- The Perfect Storm of OverutilizationJAMA, 2008
- Beyond The Efficiency Index: Finding A Better Way To Reduce Overuse And Increase Efficiency In Physician CareHealth Affairs, 2008
- Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain SocietyAnnals of Internal Medicine, 2007
- Early Experience With Pay-for-PerformanceJAMA, 2005
- Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United StatesBMJ, 2004
- Variations In The Longitudinal Efficiency Of Academic Medical CentersHealth Affairs, 2004
- The Implications of Regional Variations in Medicare Spending. Part 1: The Content, Quality, and Accessibility of CareAnnals of Internal Medicine, 2003
- Medscape's response to the Institute of Medicine Report: Crossing the quality chasm: a new health system for the 21st century.2001