Analysis and Reduction of Practice Variation
Unnecessary tests, treatments, and procedures account for a substantial proportion of national healthcare spending and have a wide range of negative effects at both patient and provider levels. Wasteful services provide no additional benefits or information, can cause unnecessary discomfort or even patient harm, and may limit service accessibility for other patients in need. Over utilization, as well as the opposite problem of underutilization, is part of the wider challenge of practice and outcome variation.
As part of the national "Choosing Wisely" campaign, a large number of clinical societies have released consensus recommendations on the appropriate use of tests and procedures routinely performed in their specialization fields. Our work examines practice variation in several such high-volume services, specifically pre-operative blood panels, x-ray imaging, and cardiovascular testing for low-risk surgical procedures. This project aims to reduce practice and outcome variation.
It was found that applications in two of the participating health systems were focusing on unnecessary preoperative tests for low-risk surgical procedures. Currently providing support on interventions and subsequent monitoring of outcome measures in one health system (two highest-volume hospitals).