AMA, TJC recommend strategies for reduction
The American Medical Association's Physician Consortium for Performance Improvement and The Joint Commission have come up with ways to reduce five commonly overused treatments — use of antibiotics for viral infections like colds, over-transfusion of red blood cells, placing tubes in ears for middle ear infusion, early elective delivery, and elective percutaneous coronary intervention (PCI).
The suggestions were published in a paper in July, "Proceedings from the National Summit on Overuse." It was the result of a meeting held last September. At the meeting, attendees defined overuse as a treatment that has little or no benefit for patients and which can drive up healthcare costs. For example, it is estimated that adults who get antibiotic treatment for viral upper respiratory infections alone lead to over $1 billion every year in unnecessary healthcare costs.
More than 100 professional organizations and associations worked to develop strategies to reduce such over-treatments. Among the specific recommendations are:
• Antibiotic use for viral upper respiratory infections — develop clinical definitions for viral and bacterial upper respiratory infections; educate the population at large on the issue.
• Appropriate blood management — develop education materials for physicians on how to avoid transfusion and promote alternatives; develop a separate informed consent process for transfusion that outlines the risks and benefits.
• Tympanostomy tubes for middle ear effusion of brief duration — develop performance measures for appropriate use of tubes; study how often they are used inappropriately in otherwise healthy kids.
• Early-term non-medically indicated elective delivery — come up with a standard calculation for gestational age; make exclusion list for early delivery as comprehensive as possible; educate patients and physicians about risks.
• Elective percutaneous coronary intervention — encourage standardized analysis/interpretation of non-invasive testing for ischemia; educate patients and physicians on the risks and benefits.
The paper and complete recommendations are available at http://www.jointcommission.org/assets/1/6/National_Summit_Overuse.pdf.