Healthcare leaders in 2014 have a plethora of critical issues to tackle. A key challenge is how to cut costs to offset dwindling reimbursements without compromising patient care. There are an increasing number of hospitals taking a hard look at variations in care: using retrospective patient data to chart which protocols produce the best outcomes. These data-driven initiatives are producing an exciting intersection of quality and cost savings that improve patient outcomes and cut down on unnecessary prescriptions, tests, and procedures.
A few weeks ago, the Journal of the American Pediatrics Association published a new study showing substantial diversity in how hospitals treat and manage tonsillitis. The study showed that in some facilities, as many as 13 percent of children suffered complications, whereas in others the rate was only 3 percent. Why the difference?
The variation in patient outcomes were primarily attributed to drugs administered before the surgery. After studying more than 140,000 patient cases spanning several year, the results showed dexamethasone administered on the day of the surgery reduced nausea, vomiting, and pain after the procedure, and consequently reduced revisits.
However, when antibiotics were administered prior to surgery (commonly thought to reduce postoperative bleeding), they did not prove to be an effect deterrent to bleeding. The cases included in the study were uncomplicated procedures where the patient was sent home the same day. The survey noted that the evidence-based processes and relevant patient outcomes should be useful to improve quality. Getting this data into the hands of doctors can reduce complications and return visits, avoid unnecessary antibiotics, and decrease the cost of patient care for the more than half a million tonsillectomies performed each year.
Texas Children’s Hospital
Here is what Texas Children’s hospital found when it got clinicians collaborating on patient data for conditions like appendicitis and asthma.
A study of outcomes for appendicitis patients resulted in a new antibiotics protocol that reduced the potential for patients to develop resistance to antibiotics, and cut down on costly prescription drugs. New guidelines for asthma treatment resulted in a fifty percent reduction in chest X-ray orders and a decrease in the average length of stay by 11 hours. Additionally, the clinical improvement team developed evidence-based action plans for clinicians to provide to patients and families. These plans help patients better manage their condition and recognize symptoms that require clinical intervention.
Physicians and Pathologists are in the hot seat on a daily basis to make decisions about care that will lead to the best possible outcomes for patients. Sometimes they need to go beyond the data and follow their instincts about a case. But that’s assuming doctors have access to evidence-based data to make decisions. Reducing variations in care isn’t about taking power away from doctors. It’s about giving them the baseline data to make informed decisions.