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Next Steps for Next Steps: The Intersection of Health Policy with Clinical Decision-Making
The Journal of Hospital Medicine introduced the Choosing Wisely®: Next Steps in Improving Healthcare Value series in 20151 as a companion to the popular Choosing Wisely®: Things We Do For No Reason™ series2 that was introduced in October in the same year. Both series were created in partnership with the American Board of Internal Medicine Foundation and were designed in the spirit of the Choosing Wisely® campaign’s mission to “promote conversations between clinicians and patients” in choosing care supported by evidence that minimizes harm, including avoidance of unnecessary treatments and tests.3 The Choosing Wisely®: Next Steps in Improving Healthcare Value series extends these principles as a forum for manuscripts that focus on translating value-based concepts into daily operations, including systems-level care delivery redesign initiatives, payment model innovations, and analyses of relevant policies or practice trends.
INITIAL EXPERIENCE
Since its inception, 16 Choosing Wisely®: Next Steps in Improving Healthcare Value manuscripts have been published, encompassing a wide range of topics such as postacute care transitions,4 the role of hospital medicine practice within accountable care organizations (ACOs),5 and quality and value at end-of-life.6
NEXT STEPS WITH NEXT STEPS
Few physicians receive health policy training.7,8 Hospital medicine practitioners are a core component of the workforce, driving change and value-based improvements at almost every inpatient facility across the country. Regardless of their background or experience, hospital medicine practitioners must interface with legislation, regulation, and other policies every day while providing patient care. Intentional, value-based improvements are more likely to succeed if those providing direct patient care understand health policies, particularly the effects of those policies on transactional, point-of-care decisions.
We are pleased to expand the Choosing Wisely®: Next Steps in Improving Healthcare Value series to include articles exploring health policy implications at the bedside. These articles will use common clinical scenarios to illuminate health policies most germane to hospital medicine practitioners and present applications of the policies as they relate to value at the level of patient–provider interactions. Each article will present a clinical scenario, explain key policy terms, address implications of specific policies in clinical practice, and propose how those policies can be improved (Appendix). Going forward, Choosing Wisely®: Next Steps in Improving Healthcare Value manuscript titles will include either “Policy in Clinical Practice” or “Improving Healthcare Value” to better establish a connection to the series and distinguish between the two article types.
The first Choosing Wisely®: Next Steps in Improving Healthcare Value—Implications of Health Policy on Clinical Decision-Making manuscript appears in this issue of the Journal of Hospital Medicine.9 As is the current practice for Choosing Wisely®: Next Steps in Improving Healthcare Value, authors are requested to send series editors a 500-word precis for review to ensure topic suitability before submission of a full manuscript. The precis, as well as any questions pertaining to the new series, can be directed to nextsteps@hospitalmedicine.org.
The authors thank the American Board of Internal Medicine Foundation for supporting this series.
1. Horwitz L, Masica A, Auerbach A. Introducing choosing wisely: Next steps in improving healthcare value. J Hosp Med. 2015;10(3): 187-189.
2. Feldman L. Choosing wisely: Things we do for no reasons. J Hosp Med. 2015;10(10):696. https://doi.org/10.1002/jhm.2425.
3. Choosing wisely: An initiative of the ABIM Foundation. Available at: http://www.choosingwisely.org/. Accessed July 8, 2019.
4. Conway S, Parekh A, Hughes A, et al. Next steps in improving healthcare value: Postacute care transitions: Developing a skilled nursing facility collaborative within an academic health system. J Hosp Med. 2019;14(3):174-177. https://doi.org/10.12788/jhm.3117.
5. Li J, Williams M. Hospitalist value in an ACO world. J Hosp Med. 2018;13(4):272-276. https://doi.org/10.12788/jhm.2965.
6. Fail R, Meier D. Improving quality of care for seriously ill patients: Opportunities for hospitalists. J Hosp Med. 2018;13(3):194-197. https://doi.org/10.12788/jhm.2896.
7. Fry C, Buntin M, Jain S. Medical schools and health policy: Adapting to the changing health care system. NEJM Catalyst, 2017. Available at: https://catalyst.nejm.org/medical-schools-health-policy-research/. Accessed July 10, 2019.
8. For doctors-in-training, a dose of health policy helps the medicine go down. National Public Radio (NPR), 2016. Available at: https://www.npr.org/sections/health-shots/2016/06/09/481207153/for-doctors-in-training-a-dose-of-health-policy-helps-the-medicine-go-down. Accessed July 10, 2019.
9. Kaiksow FA, Powell WR, Ankuda CK, et al. Policy in clinical practice: Medicare advantage and observation hospitalizations. J Hosp Med. 2020;15(1):6-8. https://doi.org/10.12788/jhm.3364.
The Journal of Hospital Medicine introduced the Choosing Wisely®: Next Steps in Improving Healthcare Value series in 20151 as a companion to the popular Choosing Wisely®: Things We Do For No Reason™ series2 that was introduced in October in the same year. Both series were created in partnership with the American Board of Internal Medicine Foundation and were designed in the spirit of the Choosing Wisely® campaign’s mission to “promote conversations between clinicians and patients” in choosing care supported by evidence that minimizes harm, including avoidance of unnecessary treatments and tests.3 The Choosing Wisely®: Next Steps in Improving Healthcare Value series extends these principles as a forum for manuscripts that focus on translating value-based concepts into daily operations, including systems-level care delivery redesign initiatives, payment model innovations, and analyses of relevant policies or practice trends.
INITIAL EXPERIENCE
Since its inception, 16 Choosing Wisely®: Next Steps in Improving Healthcare Value manuscripts have been published, encompassing a wide range of topics such as postacute care transitions,4 the role of hospital medicine practice within accountable care organizations (ACOs),5 and quality and value at end-of-life.6
NEXT STEPS WITH NEXT STEPS
Few physicians receive health policy training.7,8 Hospital medicine practitioners are a core component of the workforce, driving change and value-based improvements at almost every inpatient facility across the country. Regardless of their background or experience, hospital medicine practitioners must interface with legislation, regulation, and other policies every day while providing patient care. Intentional, value-based improvements are more likely to succeed if those providing direct patient care understand health policies, particularly the effects of those policies on transactional, point-of-care decisions.
We are pleased to expand the Choosing Wisely®: Next Steps in Improving Healthcare Value series to include articles exploring health policy implications at the bedside. These articles will use common clinical scenarios to illuminate health policies most germane to hospital medicine practitioners and present applications of the policies as they relate to value at the level of patient–provider interactions. Each article will present a clinical scenario, explain key policy terms, address implications of specific policies in clinical practice, and propose how those policies can be improved (Appendix). Going forward, Choosing Wisely®: Next Steps in Improving Healthcare Value manuscript titles will include either “Policy in Clinical Practice” or “Improving Healthcare Value” to better establish a connection to the series and distinguish between the two article types.
The first Choosing Wisely®: Next Steps in Improving Healthcare Value—Implications of Health Policy on Clinical Decision-Making manuscript appears in this issue of the Journal of Hospital Medicine.9 As is the current practice for Choosing Wisely®: Next Steps in Improving Healthcare Value, authors are requested to send series editors a 500-word precis for review to ensure topic suitability before submission of a full manuscript. The precis, as well as any questions pertaining to the new series, can be directed to nextsteps@hospitalmedicine.org.
The authors thank the American Board of Internal Medicine Foundation for supporting this series.
The Journal of Hospital Medicine introduced the Choosing Wisely®: Next Steps in Improving Healthcare Value series in 20151 as a companion to the popular Choosing Wisely®: Things We Do For No Reason™ series2 that was introduced in October in the same year. Both series were created in partnership with the American Board of Internal Medicine Foundation and were designed in the spirit of the Choosing Wisely® campaign’s mission to “promote conversations between clinicians and patients” in choosing care supported by evidence that minimizes harm, including avoidance of unnecessary treatments and tests.3 The Choosing Wisely®: Next Steps in Improving Healthcare Value series extends these principles as a forum for manuscripts that focus on translating value-based concepts into daily operations, including systems-level care delivery redesign initiatives, payment model innovations, and analyses of relevant policies or practice trends.
INITIAL EXPERIENCE
Since its inception, 16 Choosing Wisely®: Next Steps in Improving Healthcare Value manuscripts have been published, encompassing a wide range of topics such as postacute care transitions,4 the role of hospital medicine practice within accountable care organizations (ACOs),5 and quality and value at end-of-life.6
NEXT STEPS WITH NEXT STEPS
Few physicians receive health policy training.7,8 Hospital medicine practitioners are a core component of the workforce, driving change and value-based improvements at almost every inpatient facility across the country. Regardless of their background or experience, hospital medicine practitioners must interface with legislation, regulation, and other policies every day while providing patient care. Intentional, value-based improvements are more likely to succeed if those providing direct patient care understand health policies, particularly the effects of those policies on transactional, point-of-care decisions.
We are pleased to expand the Choosing Wisely®: Next Steps in Improving Healthcare Value series to include articles exploring health policy implications at the bedside. These articles will use common clinical scenarios to illuminate health policies most germane to hospital medicine practitioners and present applications of the policies as they relate to value at the level of patient–provider interactions. Each article will present a clinical scenario, explain key policy terms, address implications of specific policies in clinical practice, and propose how those policies can be improved (Appendix). Going forward, Choosing Wisely®: Next Steps in Improving Healthcare Value manuscript titles will include either “Policy in Clinical Practice” or “Improving Healthcare Value” to better establish a connection to the series and distinguish between the two article types.
The first Choosing Wisely®: Next Steps in Improving Healthcare Value—Implications of Health Policy on Clinical Decision-Making manuscript appears in this issue of the Journal of Hospital Medicine.9 As is the current practice for Choosing Wisely®: Next Steps in Improving Healthcare Value, authors are requested to send series editors a 500-word precis for review to ensure topic suitability before submission of a full manuscript. The precis, as well as any questions pertaining to the new series, can be directed to nextsteps@hospitalmedicine.org.
The authors thank the American Board of Internal Medicine Foundation for supporting this series.
1. Horwitz L, Masica A, Auerbach A. Introducing choosing wisely: Next steps in improving healthcare value. J Hosp Med. 2015;10(3): 187-189.
2. Feldman L. Choosing wisely: Things we do for no reasons. J Hosp Med. 2015;10(10):696. https://doi.org/10.1002/jhm.2425.
3. Choosing wisely: An initiative of the ABIM Foundation. Available at: http://www.choosingwisely.org/. Accessed July 8, 2019.
4. Conway S, Parekh A, Hughes A, et al. Next steps in improving healthcare value: Postacute care transitions: Developing a skilled nursing facility collaborative within an academic health system. J Hosp Med. 2019;14(3):174-177. https://doi.org/10.12788/jhm.3117.
5. Li J, Williams M. Hospitalist value in an ACO world. J Hosp Med. 2018;13(4):272-276. https://doi.org/10.12788/jhm.2965.
6. Fail R, Meier D. Improving quality of care for seriously ill patients: Opportunities for hospitalists. J Hosp Med. 2018;13(3):194-197. https://doi.org/10.12788/jhm.2896.
7. Fry C, Buntin M, Jain S. Medical schools and health policy: Adapting to the changing health care system. NEJM Catalyst, 2017. Available at: https://catalyst.nejm.org/medical-schools-health-policy-research/. Accessed July 10, 2019.
8. For doctors-in-training, a dose of health policy helps the medicine go down. National Public Radio (NPR), 2016. Available at: https://www.npr.org/sections/health-shots/2016/06/09/481207153/for-doctors-in-training-a-dose-of-health-policy-helps-the-medicine-go-down. Accessed July 10, 2019.
9. Kaiksow FA, Powell WR, Ankuda CK, et al. Policy in clinical practice: Medicare advantage and observation hospitalizations. J Hosp Med. 2020;15(1):6-8. https://doi.org/10.12788/jhm.3364.
1. Horwitz L, Masica A, Auerbach A. Introducing choosing wisely: Next steps in improving healthcare value. J Hosp Med. 2015;10(3): 187-189.
2. Feldman L. Choosing wisely: Things we do for no reasons. J Hosp Med. 2015;10(10):696. https://doi.org/10.1002/jhm.2425.
3. Choosing wisely: An initiative of the ABIM Foundation. Available at: http://www.choosingwisely.org/. Accessed July 8, 2019.
4. Conway S, Parekh A, Hughes A, et al. Next steps in improving healthcare value: Postacute care transitions: Developing a skilled nursing facility collaborative within an academic health system. J Hosp Med. 2019;14(3):174-177. https://doi.org/10.12788/jhm.3117.
5. Li J, Williams M. Hospitalist value in an ACO world. J Hosp Med. 2018;13(4):272-276. https://doi.org/10.12788/jhm.2965.
6. Fail R, Meier D. Improving quality of care for seriously ill patients: Opportunities for hospitalists. J Hosp Med. 2018;13(3):194-197. https://doi.org/10.12788/jhm.2896.
7. Fry C, Buntin M, Jain S. Medical schools and health policy: Adapting to the changing health care system. NEJM Catalyst, 2017. Available at: https://catalyst.nejm.org/medical-schools-health-policy-research/. Accessed July 10, 2019.
8. For doctors-in-training, a dose of health policy helps the medicine go down. National Public Radio (NPR), 2016. Available at: https://www.npr.org/sections/health-shots/2016/06/09/481207153/for-doctors-in-training-a-dose-of-health-policy-helps-the-medicine-go-down. Accessed July 10, 2019.
9. Kaiksow FA, Powell WR, Ankuda CK, et al. Policy in clinical practice: Medicare advantage and observation hospitalizations. J Hosp Med. 2020;15(1):6-8. https://doi.org/10.12788/jhm.3364.
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