The American journal of managed care
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Effective communication among health care providers is critically important for patient safety. Handoff of patient care from the operating room (OR) to the intensive care unit (ICU) is particularly prone to errors. The process is more complicated in an academic environment in which junior clinicians are being trained. Standardization of, and training in, transitions of care can be a crucial means to improve patient safety. ⋯ Our workflow-oriented, standardized process for handoff of care from the OR to the ICU can improve perceived communication and psychological safety, especially for junior clinicians.
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To support effective care management programs in the context of value-based care, we propose a framework categorizing care management as disease management, utilization management, and care navigation interventions.
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Poorly defined measurement impairs interinstitutional comparison, interpretation of results, and process improvement in health care operations. We sought to develop a unifying framework that could be used by administrators, practitioners, and investigators to help define and document operational performance measures that are comparable and reproducible. ⋯ The FASStR framework can guide the design, development, and implementation of operational metrics in outpatient health care settings. Further, this framework can assist investigators in the evaluation of the metrics that they are using. Overall, the FASStR framework can result in clearer, more consistent use and evaluation of outpatient performance metrics.
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Observational Study
Value-based insurance design in Louisiana: Blue Cross Blue Shield's Zero Dollar Co-pay program.
To determine whether a program that eliminated pharmacy co-pays, the Blue Cross Blue Shield of Louisiana (BCBSLA) Zero Dollar Co-pay (ZDC) program, decreased health care spending. Previous studies have found that value-based insurance designs like the ZDC program have little or no impact on total health care spending. ZDC included an expansive set of medications related to 4 chronic diseases rather than a limited set of medications for 1 or 2 chronic diseases. Additionally, ZDC focused on the most at-risk patients. ⋯ The ZDC program provides evidence that value-based insurance designs that incorporate a comprehensive set of medications and focus on populations with chronic disease can reduce spending.