A hospital's role in efforts to reduce unnecessary medical tests and procedures is increasingly getting bigger.
Work spearheaded by the American Hospital Association and the American Board of Internal Medicine Foundation aims to draw on the prominent role of hospitals in health care to help limit physicians from recommending or providing care that is more than a patient needs or is outright unnecessary.
And despite news that a new, stronger form of antibiotic may be on the way, both the AHA and the ABIM Foundation are emphasizing antibiotic overuse, a potentially major problem that could allow certain infections to go unchecked if antimicrobial resistance continues to grow.
The AHA, as part of its Physician Leadership Forum, is developing toolkits targeting specific areas of health care that can assist physicians with providing appropriate levels of care, said John Combes, senior vice president for the AHA and head of the forum.
In addition to the antimicrobial stewardship toolkit, the forum's Committee on Clinical Leadership has introduced toolkits on blood and blood products, and on treatment of conditions that are appropriate in the ambulatory care setting. In the works are toolkits on appropriate use of cardiac stents and on end-of-life care in the intensive care unit, and more may be introduced, Combes said.
"This is a really important area for health care now," he said. In an era of population health management and accountable care, "you want to be judicious with limited resources," Combes said.
Engaging patients in these efforts is key, he adds.
Separately, the ABIM Foundation announced it would be allocating $4.2 million in grant money from the Robert Wood Johnson Foundation to support the engagement of hospitals, health systems and medical groups in its Choosing Wisely campaign. The campaign's primary focus is to get medical societies to create lists of procedures that have the potential to be used inappropriately, and encouraging discussion between providers and patients about how and when to use them.
"We're continuing to have conversations on changing the attitude that more is not always better, and sometimes less is better," said Daniel Wolfson, executive vice president and chief operating officer of the ABIM Foundation.
Up to seven grantees will be chosen to target antibiotics and two other areas of potential waste or overuse found on a Choosing Wisely list.
The foundation specifically is bringing health systems, hospitals and medical groups in on this round of grants, asking them to team up with regional health organizations and one physician society and allowing for broader alignment on the effort.
"We're trying to shift [health care's] focus onto reduction of utilization, changing practice patterns," Wolfson said.