Quality 101 – Part 4: “E” is for Effective
In the first article in this series, we looked at the Institute of Medicine’s STEEEP acronym, which stands for care that is Safe, Timely, Effective, Efficient, Equitable, and Patient-Centered. Effective care is the third pillar.
The Institute for Healthcare Improvement describes effectiveness by stating, “(Healthcare) should match science, with neither underuse nor overuse of the best available techniques — every elderly heart patient who would benefit from beta-blockers should get them, and no child with a simple ear infection should get advanced antibiotics.”
Because of its ever-increasing complexity, healthcare has moved from treatment through anecdotal experience and knowledge, to one that is based on research and evidence (in cooperation with a clinical expertise and judgement, of course). But how can we be certain care is science-based, effective, and not over or underused? Some of the most common problems and solutions for effective care include:
Evidence-Based Care: As the body of medical knowledge grows, more evidence is compiled on the most effective preventive care regimes and treatments for various conditions. Many physicians subscribe to a service like UpToDate to give them immediate access to the most current available medical guidelines, ensuring they’re providing the most effective treatment.
Preventive care guidelines: For preventive care such as cancer screening, clinics should all adopt one of the national guidelines. The challenge, though, is that there is often disagreement depending on which healthcare body is making the recommendation. Does your clinic or doctor’s office follow guidance from the American College of Radiology? American Cancer Society? U.S. Preventive Services Task Force? Be sure to ask.
Overuse of services: Do your own homework on medical tests and treatments. Many common diagnostic tests are considered ineffective for diagnosis, and some can even lead to false positives, which result in more unnecessary testing. Providers and patients can use the ChoosingWisely site to look up common tests and determine the most effective alternatives.
Assuring care is effective creates better outcomes, lower costs, and higher patient satisfaction. Next time, we’ll look at efficient care. Please e-mail me with questions until then.