| Autor: |
Phil Oravetz, Christopher J White, David Carmouche, Nicole Swan, Josh Donaldson, Russel Ruhl, Czarlota Valdenor, David Paculdo, Mary Tran, John Peabody |
| Jazyk: |
angličtina |
| Rok vydání: |
2019 |
| Předmět: |
|
| Zdroj: |
Open Heart, Vol 6, Iss 1 (2019) |
| Druh dokumentu: |
article |
| ISSN: |
2053-3624 |
| DOI: |
10.1136/openhrt-2018-000994 |
| Popis: |
Objective Low 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.Methods We 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.Results Between baseline and final rounds, overall simulated quality-of-care scores improved 14.1% (p0.05).Conclusions Using simulated patients to serially measure and provide individual feedback on clinical practice significantly raises quality and reduces practice variation and costs without negatively impacting outcomes. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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