Developing a high value care programme from the bottom up: a programme of faculty-resident improvement projects targeting harmful or unnecessary care.
This quality improvement project sought to prevent harmful or unnecessary care through a combination of electronic health record alerts and provider education. Three of five completed projects undertaken demonstrated success in reducing the unneeded intervention: fewer serum creatinine tests ordered in those with end stage renal disease, fewer portable chest radiographs ordered in the intensive care unit, and fewer bone-density scans ordered in average-risk women under age 65. The authors cite leadership support, frontline clinician engagement, and inclusion of trainees as factors that contributed to success of their interventions.
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