Standardising practice in cardiology: reducing clinical variation and cost at Ochsner Health System

ObjectiveLow quality and unwarranted clinical variation harm patients and increase unnecessary costs. Effective approaches to improve clinical and economic value have been difficult. The Ochsner Health System looked to improve clinical care quality and reduce unnecessary costs in cardiology using ac...

Full description

Saved in:
Bibliographic Details
Published in:Open heart 2019-01, Vol.6 (1), p.e000994-e000994
Main Authors: Oravetz, Phil, White, Christopher J, Carmouche, David, Swan, Nicole, Donaldson, Josh, Ruhl, Russel, Valdenor, Czarlota, Paculdo, David, Tran, Mary, Peabody, John
Format: Article
Language:English
Subjects:
arrhythmia
Cardiology
Cardiovascular disease
Clinical medicine
clinical variation
coronary artery disease
Coronary vessels
Cost reduction
evidence-based medicine
Federal regulation
Health Care Delivery, Economics and Global Health Care
Health care expenditures
Health care policy
Heart
heart failure
Hospitals
Mortality
patient outcomes
Patients
Personal health
Quality
Quality control
quality improvement
Studies
Task forces
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:ObjectiveLow quality and unwarranted clinical variation harm patients and increase unnecessary costs. Effective approaches to improve clinical and economic value have been difficult. The Ochsner Health System looked to improve clinical care quality and reduce unnecessary costs in cardiology using active measurement and customised feedback.MethodsWe serially measured care decisions using online, simulated cases to capture clinical details of cardiology practice and provide individual feedback. Fifty cardiologists cared for two simulated patients in each of six assessment rounds occurring 4 months apart. Simulated patients presented with heart failure (HF), coronary artery disease (CAD), supraventricular tachyarrhythmia (SVT) or valvular heart disease. Using Ochsner’s patient-level data, we performed real-world pre–post analyses of physician practice changes, patient outcomes and costs.ResultsBetween baseline and final rounds, overall simulated quality-of-care scores improved 14.1% (p
ISSN:2053-3624
2398-595X
2053-3624
DOI:10.1136/openhrt-2018-000994