Patient Care Process
The California Public Employees' Retirement System generated significant cost savings by adopting reference pricing for hip and knee replacement procedures, causing enrollees to migrate to high-value facilities and encouraging high-price hospitals to lower their fees.
An emergency department uses an eight-variable risk assessment tool to determine which patients should be tested for undiagnosed HIV, leading to the identification of the same number of HIV-positive patients as through universal screening, thus suggesting greater cost-effectiveness.
Nurses and nurse aids in intensive care units bathe patients each day using washcloths impregnated with an antiseptic agent, leading to a significant reduction in hospital-acquired infections.
Certified peer specialists provide emotional support, education, links to community services, and other support to individuals with co-occurring medical and mental health diagnoses at two Michigan federally qualified health centers, generating high levels of satisfaction and anecdotal reports of improvements in physical and mental health.
Community health workers known as promotores enhance access to culturally competent mental health education and services, leading to improvements in mental health status and literacy for elderly racial and ethnic minorities.
A local foundation developed community-based testing programs and partnerships with medical homes to provide real-time linkages to HIV care to newly diagnosed patients and to support these patients in transitioning to care, nearly doubling the number of patients initiating treatment.
Emergency department and urgent care physicians and nurses use a protocol to help them decide how to treat patients complaining of pain who may be abusing controlled substances, leading to significantly fewer such patients receiving prescriptions for opioids.
A public–private urban health partnership develops multiple initiatives to expand access to high-quality, coordinated health care for vulnerable residents, leading to shorter wait times for appointments, improvements in patient–provider continuity, and reductions in readmissions and emergency department use.
The State of Minnesota uses financial rewards and penalties to fund nursing home–initiated quality improvement projects through a competitive bidding process, leading to improvements in the quality of care.
A primary care medical home for patients with disabilities and complex, chronic medical conditions emphasizes patient engagement and care coordination among medical specialties and social service providers, leading to enhanced access to care, better self-management skills, more days of good health, fewer hospitalizations, and lower costs.