Development and Evaluation of High-Value Pediatrics: A High-Value Care Pediatric Resident Curriculum.

TitleDevelopment and Evaluation of High-Value Pediatrics: A High-Value Care Pediatric Resident Curriculum.
Publication TypeJournal Article
Year of Publication2018
AuthorsDewan M, Herrmann LE, Tchou MJ, Parsons A, Muthu N, Tenney-Soeiro R, Fieldston E, Lindell RB, Dziorny A, Gosdin C, Bamat TW
JournalHosp Pediatr
Volume8
Issue12
Pagination785-792
Date Published2018 12
ISSN2154-1663
KeywordsAccreditation, Clinical Competence, Cost Savings, Cost-Benefit Analysis, Curriculum, Delivery of Health Care, Faculty, Medical, Health Services Research, Humans, Internship and Residency, Pediatrics, Quality of Health Care, United States
Abstract

Low-value health care is pervasive in the United States, and clinicians need to be trained to be stewards of health care resources. Despite a mandate by the Accreditation Council for Graduate Medical Education to educate trainee physicians on cost awareness, only 10% of pediatric residency programs have a high-value care (HVC) curriculum. To meet this need, we set out to develop and evaluate the impact of High-Value Pediatrics, an open-access HVC curriculum. High-Value Pediatrics is a 3-part curriculum that includes 4 standardized didactics, monthly interactive morning reports, and an embedded HVC improvement project. Curriculum evaluation through an anonymous, voluntary survey revealed an improvement in the self-reported knowledge of health care costs, charges, reimbursement, and value ( < .05). Qualitative results revealed self-reported behavior changes, and HVC improvement projects resulted in higher-value patient care. The implementation of High-Value Pediatrics is feasible and reveals improved knowledge and attitudes about HVC. HVC improvement projects augmented curricular knowledge gains and revealed behavior changes. It is imperative that formal high-value education be taught to every pediatric trainee to lead the culture change that is necessary to turn the tide against low-value health care. In addition, simultaneous work on faculty education and attention to the hidden curriculum of low-value care is needed for sustained and long-term improvements.

DOI10.1542/hpeds.2018-0115
Alternate JournalHosp Pediatr
PubMed ID30425056
Grant ListL40 HD085270 / HD / NICHD NIH HHS / United States