Teaching Residents Systems-Based Practice Through a Hospital Cost-Reduction Program: A "Win-Win" Situation

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 compr...

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Bibliographic Details
Published in:	Teaching and learning in medicine Vol. 18; no. 2; pp. 150 - 152
Main Authors:	Englander, Robert, Agostinucci, William, Zalneraiti, Edwin, Carraccio, Carol L.
Format:	Journal Article
Language:	English
Published:	United States Lawrence Erlbaum Associates, Inc 01-04-2006
Subjects:	Clinical Laboratory Techniques - economics Cost Control - methods Education, Medical, Graduate Hospital Costs Hospitals, Pediatric Humans Internship and Residency Ohio Point-of-Care Systems - utilization Ohio
Online Access:	Get full text
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Summary:	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 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 iSTAT(r) went from 40% of potential iSTAT® tests being ordered on the iSTAT® to 98%, with an estimated $549,780 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1040-1334 1532-8015
DOI:	10.1207/s15328015tlm1802_10