The Iowa Healthcare Collaborative (IHC) used its grant to advance Choosing Wisely® and increase physician engagement in health care transformation and improve patient and family engagement in their medical care throughout Iowa.
The Choosing Wisely recommendations aligned the work of the campaign with the work already being done in the state. As the sole Hospital Engagement Network (HEN) serving the Iowa region, IHC was driving the key quality improvement efforts of the Partnership for Patients campaign with 127 hospitals. Through this work, IHC was able to implement Choosing Wisely within the hospitals and among physicians serving these communities. The sole regional collaborative in the state, IHC is a natural convener of physician-based work groups to advance the campaign at a state level. To educate hospitals, physicians, public health partners, employers and insurers, IHC created an educational webcast introducing Choosing Wisely to Iowa.
The “Iowa 5” Choosing Wisely recommendations IHC focused on included:
- Don’t obtain imaging studies in patients with non-specific low back pain; and don’t do imaging for low back pain within the first six weeks, unless red flags are present.
- Don’t do imaging for uncomplicated headache. Imaging headache pains absent specific risk factors for structural disease is not likely to change management or improve outcomes.
- In the evaluation of simple syncope and a normal neurological examination, don’t obtain brain imaging studies (CT or MRI).
- Avoid use of computed tomography (CT) scans in the immediate evaluation of minor head injuries.
- Don’t order sinus CT or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis.
In the second year of its grant, IHC focused on raising awareness through media and news coverage, and worked with providers on implementing the “Iowa 5” recommendations and ways to track improvement with statewide data. IHC also partnered with the largest commercial insurer in the state to equip consumers with information on the campaign.
The Iowa Healthcare Collaborative is a provider-led nonprofit organization dedicated to promoting a culture of continuous improvement in health care. IHC’s mission is exceptional health care in Iowa. Created in 2004 through a partnership between the Iowa Hospital Association and the Iowa Medical Society, it uses a multi-stakeholder approach to bring together and engage stakeholders to share data and rapidly deploy best practices.