Volume 9, Issue 10 p. 671-677
Transforming Healthcare

Development of a hospital-based program focused on improving healthcare value

Christopher Moriates MD

Corresponding Author

Christopher Moriates MD

Division of Hospital Medicine, University of California, San Francisco, San Francisco, California

Address for correspondence and reprint requests: Christopher Moriates, MD, Assistant Clinical Professor, Division of Hospital Medicine, University of California, San Francisco, 505 Parnassus Ave, M1287, San Francisco, CA 94143; Telephone: 415-476-9852; Fax: 415-502-1963; E-mail: [email protected]Search for more papers by this author
Michelle Mourad MD

Michelle Mourad MD

Division of Hospital Medicine, University of California, San Francisco, San Francisco, California

Search for more papers by this author
Maria Novelero MPA

Maria Novelero MPA

Division of Hospital Medicine, University of California, San Francisco, San Francisco, California

Search for more papers by this author
Robert M. Wachter MD

Robert M. Wachter MD

Division of Hospital Medicine, University of California, San Francisco, San Francisco, California

Search for more papers by this author
First published: 01 July 2014
Citations: 18

Abstract

BACKGROUND

Frontline physicians face increasing pressure to improve the quality of care they deliver while simultaneously decreasing healthcare costs. Although hospitals and physicians are beginning to implement initiatives targeting this new goal of healthcare value, few of them have a well-developed infrastructure to support this work.

METHODS

In March 2012, we launched a high-value care (HVC) program within the Division of Hospital Medicine at the University of California, San Francisco. The HVC program is co-led by a physician and the division's administrator, and includes other hospitalists, resident physicians, pharmacists, and administrators. The program aims to (1) use financial and clinical data to identify areas with clear evidence of waste in the hospital, (2) promote evidence-based interventions that improve both quality of care and value, and (3) pair interventions with evidence-based cost awareness education to drive culture change.

RESULTS

We identified 6 ongoing projects during our first year. Preliminary data for our inaugural projects are encouraging. One initiative, which targeted decreasing nebulizer use on a high-acuity medical floor (often using metered-dose inhalers instead) led to a decrease in rates of more than 50%.

CONCLUSIONS

The HVC program is proving to be a successful mechanism to promote improved healthcare value and clinician engagement. Journal of Hospital Medicine 2014;9:671–677. © 2014 Society of Hospital Medicine