As a current and previous grantee, multi-stakeholder regional health improvement collaborative Maine Quality Counts (MQC) lead efforts throughout Maine’s Midcoast and Greater Bangor regions to reduce:
- the use of antibiotics for adult bronchitis,
- diagnostic testing for low back pain and;
- prescriptions for benzodiazepines for adults 60 and over.
MQC relied on community organizing principles to promote culture change within each region and worked with the Maine Medical Association, Maine Osteopathic Association, Consumers for Affordable Healthcare and Maine Area Agencies on Aging. They also worked with local partners such as Mid Coast Health System as well as Greater Bangor’s Penobscot Community Health Care and St. Joseph Healthcare.
Clinician interventions included educational sessions and networking meetings, the identification of “clinical champions” in both primary care and specialty settings, the use of point-of-care decision-support tools and reminders, and measurement and periodic performance feedback.
To reach consumers and raise public awareness, MQC launched a grassroots campaign to bring messages about Choosing Wisely into a range of community settings, including public libraries, schools, churches, businesses, civic organizations and neighborhood groups through town halls, employer engagement and community collaboration.
Stories of Success
Charting Cultural Change in Maine
“In Maine, the participating sites view their Choosing Wisely work as a cultural movement and draw inspiration from movements like the cultural and social transition away from tobacco products, as well as the movement to embrace healthy and locally grown food,” said Kellie Slate Vitcavage, MS, Project Manager for Maine Quality Counts. “In order to do this, they take a flexible approach to all that they do. To address the opioid epidemic affecting Bangor, for instance, they provide Choosing Wisely opioid resources to the community created by Consumer Reports, including a brochure communicating five questions patients should ask their doctor. This aligns with overall goals to reduce unnecessary or harmful care and shows how organizations can adapt the Choosing Wisely lessons to address the specific needs and concerns of a community.”
In order to determine the right partners for this grassroots movement, Maine Quality Counts first did an environmental scan and established health care provider leads in hospitals throughout the region, and sought out partnerships with area agencies on aging. From these beginnings, they extended their reach into the fabric of the communities in their two regions to help people understand and share the Choosing Wisely message.
“We really are gaining traction,” Kellie said. “This all started from moving health care outside of the clinical practice, and empowering patients to move health care in the direction they needed it to move. This is an incredible opportunity to educate, to look at things differently, to try alternatives, and start on a foundation of shared decision-making.”
- “Choosing Wisely and State Innovation Models Align in Maine” – Updates From The Field, Sept. 2014
- “Choosing Wisely Changing How Maine Health Systems and Practices Deliver Care” – Updates From The Field, July 2014