NEJM Catalyst
Aaron George, DO and Maulik Joshi, DrPH
October 19, 2022
Site Editor:
Joaquim Cardoso MSc.
health transformation institute (HTI) — in search of excellence
October 20, 2022
Summary
Who is doing it? What is the motivation? What is the target?
- Meritus Health has undertaken a strategic and focused effort to reduce low-value care in its health system.
- Aligned with its strategic goal to reduce patient harm to zero by 2030, among other initiatives, Meritus Health set a specific annual operating plan aim to reduce unnecessary laboratory (lab) tests and imaging by 10,000 procedures in fiscal year 2022.
- Although the health organization completes more than 1 million lab tests per year, this first step would represent about 5.5% of the roughly 135,000 lab tests and 50,000 imaging procedures that were targeted, compared with the previous fiscal year.
Aligned with its strategic goal to reduce patient harm to zero by 2030, among other initiatives, Meritus Health set a specific annual operating plan aim to reduce unnecessary laboratory (lab) tests and imaging by by 5.5 %
What does it take?
- This effort included convening an unnecessary-utilization workgroup alongside targeted task forces that engaged multidisciplinary stakeholders longitudinally throughout the year.
- Additionally, Meritus leveraged an in-house Data Atlas platform to track improvement on a daily, weekly, and monthly basis.
- Data — including individual provider performance — were shared transparently.
This effort included: (1) convening an unnecessary-utilization workgroup, (2) alongside targeted task forces that engaged multidisciplinary stakeholders longitudinally throughout the year, (3) an in-house Data Atlas platform to track improvement on a daily, weekly, and monthly basis.
What are the results?
- In the first year, the initiative exceeded its goal by achieving more than 32,000 fewer tests and images compared with the previous fiscal year, a reduction of about 17.3% for those tests targeted.
- This leadership effort leverages the tried-and-true quality improvement elements of transparency and feedback of actionable data to reduce a low-value service, which creates opportunity for reproducibility.
In the first year, the initiative exceeded its goal achieving a reduction of about 17.3% for those tests targeted.
This leadership effort leverages the tried-and-true quality improvement elements of transparency and feedback of actionable data to reduce a low-value service, which creates opportunity for reproducibility.
What are the next steps?
- Meritus intends to build upon the success of the first year of this initiative, with efforts to both sustain success in targeted reduction and expand to additional areas of care delivery.
In the first year, the initiative exceeded its goal by achieving more than 32,000 fewer tests and images compared with the previous fiscal year, a reduction of about 17.3% for those tests targeted.
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Originally published at https://catalyst.nejm.org on October 19, 2022.
