February 2021 Learning Network Resources

Tuesday, March 16, 2021 @ 4PM EST

Join us for “Tools for Building Institutional Trust” with speaker Jennifer Stephens, MPH, from Essential Hospitals.

Register here.

Trust in Healthcare

Sharieff GQ. Building Organizational Trust During a Pandemic. NEJM Catalyst. January 2021

“Engendering trust among physicians, staff, and patients has been paramount during the pandemic, and leadership at Scripps Health established several mechanisms for making sure that communication was regular, transparent, and attuned to the needs of the community.”

Bajaj SS, et alt. Beyond Tuskegee — Vaccine Distrust and Everyday Racism. NEJM. January 2021

“Though this recognition critically highlights the concordance between the Black population and the National Institutes of Health’s lead scientist for coronavirus vaccine research, we need more public health messaging coming directly from Black health leaders, a challenge given that only 5% of U.S. physicians are Black. Black scientists sharing their stories is paramount because they can more directly relate and speak to their communities’ needs. The NAACP study found that Black Americans were twice as likely to trust a messenger of their own racial/ethnic group than one from outside it. When trust is in short supply everywhere, we need all hands on deck to begin rebuilding trust in health care. We believe the best way to learn from the atrocities of the past is to change our present.”

Benjamins MR, et alt. Comparison of All-Cause Mortality Rates and Inequities Between Black and White Populations Across the 30 Most Populous US Cities. JAMA. January 2021

“In this study, mortality rates and inequities between Black and White populations varied substantially among the largest US cities. City leaders and other health advocates can use these types of local data on the burden of death and health inequities in their jurisdictions to increase awareness and advocacy related to racial health inequities, to guide the allocation of local resources, to monitor trends over time, and to highlight effective population health strategies.”

Recht H, et alt. Black Americans Are Getting Vaccinated at Lower Rates Than White Americans. Kaiser Health News. January 2021

“Black Americans are receiving covid vaccinations at dramatically lower rates than white Americans in the first weeks of the chaotic rollout, according to a new KHN analysis.”

Blogs, Issue Briefs, Opinion Pieces and More…

Unnecessary Surgery: When the Doctor Gambles, Who Puts Up the Stakes? Clore Law Group. January 2021

“The fundamental question for a surgeon who recommends an operation is whether the potential benefits outweigh the known risks.  Surgery carries risks. We all know that. The question is how badly does the person need surgery, and what are the risks (and severity of risks) of complications that can happen? When the risk of serious complications exceed the risk of potential benefits, common sense tells us that surgery is not a wise choice. So, why do doctors still recommend and order unnecessary surgeries in this day and age?”

Are early detection and treatment always best? Harvard Health Publishing. January 2021

“The importance of early diagnosis and early treatment is clear for certain conditions. But for others, it’s oversold. The case could be made that our ability to test has outpaced our ability to interpret the results. Just because we can test for hundreds of diseases doesn’t mean we should.”

Journals

Kherad O, et alt.Physician Assessment and Feedback During Quality Circle to Reduce Low-Value Services in Outpatients: a Pre-Post Quality Improvement Study. Journal of General Internal Medicine. February 2021

“Limiting overuse in medicine is very challenging and dedicated discussion and real-time review of actionable data may help.”

Wang T, et alt. Variations in Persistent Use of Low-Value Breast Cancer Surgery. JAMA Surgery. February 2021

“Interfacility variation demonstrates a performance gap and an opportunity for formal deimplementation efforts targeting each procedure. Several facility-level characteristics were associated with differential deimplementation and performance.”

Moleman M, et alt. Toward High-Value, Cost-Conscious Care – Supporting Future Doctors to Adopt a Role as Stewards of a Sustainable Healthcare System. Taylor & Francis Online. February 2021

“Strategies to promote physician stewardship go beyond the formal curriculum and require a transformation in the informal educational system from one that almost exclusively focuses on medical discussions to one that also considers value and cost as part of medical decision-making. The HVCCC carriers propose a set of strategies and system adaptations that could aid the transformation toward a HVCCC supporting context.”

Beeber AS, et alt. Nurse Decision-making for Suspected Urinary Tract Infections in Nursing Homes: Potential Targets to Reduce Antibiotic Overuse. Journal of the American Medical Directors Association. January 2021

“Interventions that help nurses take the time to deliberate over the information they receive and empower them to use the time to respond to the signs and symptoms of UTIs with appropriate symptom management strategies could potentially relieve NH resident suffering. These efforts could impact the overprescribing of antimicrobials and enhance antimicrobial stewardship for NH residents with suspected UTIs.”

Armistead LT, et alt. Integrating targeted consultant pharmacists into a new collaborative care model to reduce the risk of falls in older adults owing to the overuse of opioids and benzodiazepines. Journal of the American Pharmacists Association. January 2021

“As a result of the risks associated with opioids and benzodiazepines, health professionals have been working to decrease the use of these medications among their patients. However, tapering opioids and benzodiazepines is a time-intensive process that many providers do not feel equipped to address and one that many patients resist. The overuse of opioids and benzodiazepines in older adults, as well as the increase in fall-risk that these medications pose, is a public health concern for which practical, effective, and affordable solutions need to be developed.”

Bosserman LD, et alt. Integrating Academic and Community Cancer Care and Research through Multidisciplinary Oncology Pathways for Value-Based Care: A Review and the City of Hope Experience. PMC. January 2021

“Multidisciplinary oncology care pathways are essential components of value-based care and their payment metrics. Oncology pathways are evidence-based, standardized but personalizable care plans to guide cancer care. Pathways have been developed and studied for the major medical, surgical, radiation, and supportive oncology disciplines to support decision-making, streamline care, and optimize outcomes. Implementing multidisciplinary oncology pathways can facilitate comprehensive care plans for each cancer patient throughout their cancer journey and across large multisite delivery systems.”

Media

Why it’s so hard to cut waste in health care. The New York Times. January 2021

“One reason it is so hard to trim waste is that physicians and regulators have already eliminated so many demonstrably harmful or useless treatments. Patients are no longer offered patent medicines, routine bloodlettings or lobotomies.”

After A Year Battling COVID-19, Drug Treatments Get A Mixed Report Card. NPR. January 2021

“Drugs to treat COVID-19 are being fast-tracked for development, but the pace can’t match the astonishing speed that gave birth to the vaccines. But one year into the pandemic, there has been strong progress toward effective drug treatments, and the groundwork has been laid for drugs to kill the virus and arrest disease. If you want to see a scorecard on COVID-19 drugs, you can check out two good sources. Expert panels are constantly updating treatment guidelines for both the National Institutes of Health and the Infectious Diseases Society of America.”