AMA Wire

Wednesday, July 17, 2013

This Week's News

Leading quality groups put forth strategies to reduce treatment overuse

Leading quality groups put forth strategies to reduce treatment overuse

A paper released last week by two of the nation's top health care quality organizations recommends a series of strategies to cultivate appropriate use of five common medical interventions and treatments.

The recommendations, set forth by the AMA-Convened Physician Consortium for Performance Improvement® (PCPI®) and the Joint Commission, aim to improve the quality and safety of patient care and extend finite health care resources. The groups look at five interventions and treatments that often are overused and outline strategies to inspire physician leadership, support a culture of safety and mindfulness, and promote further study and patient education.

"The AMA is committed to improving health outcomes," AMA President Ardis Dee Hoven, MD, said in a news release. "This important work will help health care professionals ensure that the right patient gets the right treatment at the right time."

Antibiotics for viral upper respiratory infections. The groups recommend developing clinical definitions for viral and bacterial infections, aligning current national guidelines, partnering with the U.S. Centers for Disease Control and Prevention, and initiating a national education campaign about the overuse of antibiotics for these infections.

Blood management. The suggested strategy is to produce clinical education materials for doctors, expand education on transfusion avoidance and appropriate alternatives, and develop an informed consent process that communicates the risks and benefits of transfusion.

Tympanostomy tubes for middle ear effusion of brief duration. Steps for addressing overuse of this treatment include developing performance measures for appropriate use, determining the frequency with which tympanostomy tubes are used for healthy children with inappropriate indications and conducting national research on such related issues as shared decision-making with children's caregivers.

Elective early term delivery that is not medically indicated. The groups suggest standardizing how gestational age is calculated, making the list of early elective delivery indications and exclusions as comprehensive as possible, and educating patients and physicians about the risks of such early deliveries.

Elective percutaneous coronary intervention. The strategy for this intervention is to encourage standardization in catheterization and interventional procedure reports and in the analysis and interpretation of non-invasive testing for ischemia. The groups also recommend focusing on informed consent, promoting patient awareness of the benefits and risks of the intervention, and providing public and professional education.

"As part of our strategic focus on improving health outcomes, one of our goals is to contribute to the appropriate use of finite health care resources," Dr. Hoven said. "This will help us achieve that goal."

The paper also gives an overview of the 2012 National Summit on Overuse that brought together representatives from 112 professional organizations and associations to discuss these five interventions and treatments.