Background: Questionnaires administered to the house staff has identified a lack of high value care as a suggestion area of improvement for the program. Additionally, the attending staff has identified the practice of high value care as an area of improvement among our residents. A number of curricula have been developed to help address these topics, most notably the ACP High Value Care curriculum and the ABIM Choosing Wisely initiative, and our institution has been investigating the most effective way to introduce these topics. Purpose: To determine if routine interactive and case-based Morning Report sessions are effective in introduing house staff to the ACP High Value Care curriculum and choosingwisely.org, and if introduction to this material is likely to affect clinical decision-making practices. Description: A series of interactive morning report sessions were authored by the chief resident. Attendees of the morning report break up into teams based on experience (i.e., medical students vs. interns vs. residents vs. attendings) and attempt to arrive at the diagnosis of a prepared case. Three rounds of diagnostic testing is allowed. At the end of the session, the cost of the workup, including clinic visits and hospital stay, is calculated with prizes awarded to the team providing the most cost-effective and appropriate care. This is followed by a presentation outlining pertinent concepts from the ACP High Value Care curriculum and choosingwisely.org. Conclusions: The residents ranked their prior exposure to high value curriculum, familiarity with the ACP High Value Care program and familiarity with choosingwisely.org as 3.6, 3.0 and 4.2 respectively on a 1-10 scale. Following the session, they rated their likelihood of independently accessing the ACP High Value Care curriculum and choosingwisely.org as 7.2 and 8.1 respectively on a 1-10 scale. Attendees also rated the effectiveness of the sessions and their interest in future similar sessions as 8.2 and 8.3 respectively on a 1-10 scale. Discussion/Reflection/Lessons Learned: An interactive and competition-based education approach to introducing high value care curriculum was successful both at increasing awareness among the house staff of the core topics addressed in the ACP High Value Care curriculum as well as promoting the utilization and review of choosingwisely.org.
Vestal, Richard and Jennifer Jernigan. "Interactive implementation of high value care." (2014). http://digitalrepository.unm.edu/hostpitalmed_pubs/33