Case Study: Helping the Underserved Discuss Overuse
United Community and Family Services (UCFS) is a federally qualified health center that provides comprehensive primary care to historically underserved populations throughout Connecticut. Services include adult and pediatric primary care, women’s health, geriatric assessment and management, dental care, outpatient behavioral health, community-based behavioral health, community outreach and elder care.
Problem
Recognizing that patients of FQHCs may have a history of being or feeling underserved, UCFS identified a strategic need to introduce the idea that reducing care that has little or no benefit is in a patient’s interest and doesn’t constitute denying care based on economic savings or institutional biases.
Solution
UCFS practices began promoting the Choosing Wisely educational resources to encourage conversations about overuse. After testing the materials in practice, UCFS sponsored four focus groups that included clinicians, community health care workers, and underserved English- and Spanish-speaking patients in order to gather input about care experiences, trust and patient-provider relationships.
Bilingual Choosing Wisely patient resources were used, and the “5 QUESTIONS to Ask Your Doctor” poster was highlighted. Clinicians and 250 patients provided survey feedback on their perceived comfort level with clinical care conversations.
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