Literature DB >> 16626274

Teaching residents systems-based practice through a hospital cost-reduction program: a "win-win" situation.

Robert Englander1, William Agostinucci, Edwin Zalneraiti, Carol L Carraccio.   

Abstract

BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project challenges residency programs to teach and evaluate competence in 6 domains, including systems-based practice (SBP). One element of SBP is to "practice cost-effective health care ... that does not compromise quality." Institutional cost-reduction efforts included targeting laboratory fees by using point-of-care testing with an iSTAT machine rather than in the central laboratory. Predicted cost savings were 50,000 US dollars per month. Because residents are primary users of laboratory resources, the authors engaged them in the process and implementation of system redesign. DESCRIPTION: The residents identified barriers to use of the iSTAT and solutions to overcome those barriers. EVALUATION: As a result of resident solutions, use of the iSTATwent from 40% of potential iSTATtests being ordered on the iSTAT to 98%, with an estimated 549,780 US dollars per year in savings to the hospital.
CONCLUSION: Involving residents in hospital cost-reduction efforts allows both teaching and evaluation of competence in SBP while realizing significant cost savings.

Mesh:

Year:  2006        PMID: 16626274     DOI: 10.1207/s15328015tlm1802_10

Source DB:  PubMed          Journal:  Teach Learn Med        ISSN: 1040-1334            Impact factor:   2.414


  8 in total

1.  Reconsidering Systems-Based Practice: Advancing Structural Competency, Health Equity, and Social Responsibility in Graduate Medical Education.

Authors:  Enrico G Castillo; Jessica Isom; Katrina L DeBonis; Ayana Jordan; Joel T Braslow; Robert Rohrbaugh
Journal:  Acad Med       Date:  2020-12       Impact factor: 6.893

2.  Systems-based practice defined: taxonomy development and role identification for competency assessment of residents.

Authors:  Mark J Graham; Zoon Naqvi; John Encandela; Kelli J Harding; Madhabi Chatterji
Journal:  J Grad Med Educ       Date:  2009-09

3.  Teaching systems-based competency in anesthesiology residency: development of an education and assessment tool.

Authors:  Roy G Soto; Daniel S Cormican; Christopher J Gallagher; Peggy A Seidman
Journal:  J Grad Med Educ       Date:  2010-06

4.  A multidisciplinary approach for teaching systems-based practice to internal medicine residents.

Authors:  Christopher Nabors; Stephen J Peterson; Roger Weems; Leanne Forman; Arif Mumtaz; Randy Goldberg; Kausik Kar; Joseph A Borges; Ida Doctor; Orpha Lubben; Nisha Pherwani; William H Frishman
Journal:  J Grad Med Educ       Date:  2011-03

5.  Teaching health care workers to adopt a systems perspective for improved control and prevention of health care-associated infections.

Authors:  A R Ruis; David Williamson Shaffer; Daniel K Shirley; Nasia Safdar
Journal:  Am J Infect Control       Date:  2016-07-14       Impact factor: 2.918

6.  Development of the objective structured system-interaction examination.

Authors:  Susan Hingle; Richard B Rosher; Sherry Robinson; Nancy McCann-Stone; Christine Todd; Michael Clark
Journal:  J Grad Med Educ       Date:  2009-09

7.  Systems-Based Practice: Time to Finally Adopt the Orphan Competency.

Authors:  Susan Guralnick; Emily Fondahn; Alpesh Amin; Edward A Bittner
Journal:  J Grad Med Educ       Date:  2021-04-23

Review 8.  Where do we go from here? Moving from systems-based practice process measures to true competency via developmental milestones.

Authors:  Johanna Martinez; Erica Phillips; Christina Harris
Journal:  Med Educ Online       Date:  2014-06-27
  8 in total

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