Washington Health Alliance
The Washington Health Alliance (the Alliance), a purchaser-led regional health improvement collaborative and previous grantee, partnered with the Washington State Medical Association (WSMA) to use Choosing Wisely to improve health care in Washington state. Both were grantees in the first round of Choosing Wisely grants.
Along with health care systems Group Health Cooperative and Swedish Health Services, the Alliance and WSMA operated a “Change Three Things” initiative, targeting:
- the overuse of antibiotics for upper respiratory viral infections;
- imaging for uncomplicated headaches; and
- overly frequent Pap tests for women between the ages of 30 and 65.
Key Interventions
Interventions included:
- providing transparent and timely feedback to clinicians within the health systems about their ordering practices;
- testing clinical decision support strategies in their electronic medical record systems; and
- supporting academic detailing, the sharing of information about best practices with all members of a care team.
The grant partners also worked with the larger Washington State Choosing Wisely Task Force—which includes medical leaders from 22 large and small health care organizations in the state—to engage consumers, purchasers, payers and other stakeholders in the effort to reduce unnecessary care. The Alliance coordinated consumer communication materials across these organizations, while WSMA worked with its physician members to enhance their ability to have effective conversations with their patients about appropriate care.
Stories of Success
Washington’s Greatest Resource: One Another
Group Health Cooperative has a long history of working on principles dear to Choosing Wisely, including using clinical evidence to improve how they deliver care. Group Health has invested heavily in the concept of “shared decision-making,” which emphasizes working with patients to understand their values and preferences to ensure they receive the care that they need—and want. As a result, demonstrating empathy is at the core of Group Health’s strategy; an insight the organization relays via physician communication training.
“When we look at data about the variation in use of services, we always find someone who’s figured it out,” said Matt Handley, MD, Medical Director for Quality, Group Health Cooperative. “When we collect this data on physicians’ own practice patterns, physicians are always surprised by their practice patterns. This provides the evidence for physicians to explore what works well for them in an open and trusting environment that fosters learning and growth. No matter how smart or talented we are, if we’re doing it alone, we’ll never be as successful as if we’re doing it together.”
Matt has taken his “sum is greater than its parts” philosophy to heart not just at Group Health but for the state of Washington. He chairs the Washington State Choosing Wisely Task Force, a group committed to ensuring safe, high-quality health care for patients in Washington State through the reduction of health care overuse and waste. The Washington State Choosing Wisely Task Force strives to change behaviors and create measurable improvement through a variety of tactics: education, outreach, building practice models and frameworks and developing resources and toolkits for providers and health care systems. Task Force member organizations have committed to state-wide reductions of the identified focus areas.
