Preventive care processes
Specially trained and certified lay workers known as “Grand-Aides” use illness-specific protocols to ensure that patients receive appropriate treatment in primary care settings and to ease the transition from hospital to home after discharge. The primary care-based program has reduced unnecessary visits and demonstrated the potential to reduce costs. Early data from one hospital program show significant reductions in readmissions.
As required by law, hospitals in New York track and report information on select hospital-acquired infections to the State Department of Health, which publicly releases hospital-specific performance data and supports hospitals with quality improvement initiatives; the program has reduced infection rates and generated substantial cost savings.
A partnership among a periodontist, hospitals, state-funded health clinics, and area dentists enhances access to comprehensive dental care and education about oral hygiene to thousands of low-income pregnant women.
Financial incentives of up to $200 did not produce a meaningful decline in blood glucose levels in African-American veterans with diabetes.
African-American veterans with diabetes who had their blood glucose under control mentored patients with a similar background who did not, leading to significant reductions in blood glucose levels.
A regional health system with 21 hospitals implemented a comprehensive sepsis care initiative featuring proactive screening in the emergency department, algorithms to guide evidence-based treatment, and tools to support the provision of appropriate care, leading to better diagnosis, more appropriate care, lower mortality rates, and more patients meeting clinical targets.
A large health plan's multifaceted program promotes appropriate prescribing and monitoring of opioid therapy for patients with chronic pain not caused by cancer, leading to enhanced physician knowledge and confidence related to prescribing, greater use of care plans and drug screening, and fewer patients on high-dose therapy.
In combination with training and support for pediatric providers, a large health maintenance organization offered separate parent and teen group meetings in primary care clinics to promote behavior changes in overweight and obese teenage girls, leading to improvements in eating habits, body mass index, and psychosocial outcomes.
Registered nurses travel to farms to provide free preventive health and occupational safety screenings to farmers, leading to better eating habits and cholesterol levels, high attendance at followup appointments, and anecdotal reports of safety improvements.
A Medicaid managed care plan offers a patient-specific pay-for-performance program tailored to the needs of both large and small practices serving vulnerable populations, leading to improvements in immunization rates and diabetes care.