Navigation Links
Experts describe ways to eliminate wasteful medical tests and procedures
Date:8/18/2013

Medical organizations are participating in a campaign to help clinicians and patients avoid wasteful and sometimes harmful medical interventions. Recently, experts in pediatric and adult health from diverse geographic locations of the United States and from a mix of academic and non- academic settings shared their experiences, consulted their colleagues, and analyzed numerous studies in the medical literature to determine the top recommendations for improving healthcare value. Following these recommendations, which are outlined in a new study published today in the Journal of Hospital Medicine, will lower costs and lead to better care for patients.

Experts estimate that waste constitutes up to 20% of health care expenditures in the United States. To address this problem a number of national medical societies have joined the Choosing Wisely campaign, with each creating a list of five common but sometimes unnecessary, tests, therapies, or procedures in their fields that patients and physicians should question and discuss. The Society of Hospital Medicine joined this effort in 2012, and it asked experts to create such lists regarding the care provided to hospitalized adults and children.

In addition to including the Choosing Wisely lists for pediatric and adult hospitalists, the new articles provide details about the methodologies used to create them. The details can serve as a blueprint for other healthcare organizations interested in researching and developing lists of potentially over-used or harmful interventions.

The recommendations five for hospitalists and five for pediatric hospitalists were published jointly by the American Board of Internal Medicine Foundation and the Society of Hospital Medicine in early 2013.

The top five recommendations proposed for hospitalized children are:

  1. Don't order chest radiographs in children with asthma or bronchiolitis. This has the potential to decrease costs, reduce radiation exposure, and minimize the overuse of antibiotics due to false positive results.

  2. Don't use bronchodilators in children with bronchiolitis because the agents have minimal or no treatment effects.

  3. Don't use systemic corticosteroids in children under two years of age with a lower respiratory tract infection because the treatment is potentially harmful and provides little or no benefit.

  4. Don't treat gastroesophageal reflux in infants routinely with acid suppression therapy, such as proton pump inhibitors. Studies show that such treatment is no more effective than placebo in infants, and it may cause side effects.

  5. Don't use continuous pulse oximetrya method for measuring oxygen saturation in the bloodroutinely in children with acute respiratory illness unless they are on supplemental oxygen. Continuous monitoring of oxygen saturations in hospitalized infants with bronchiolitis may lead to overdiagnosis of hypoxemia, increased hospital duration, and the use of oxygen that is of no apparent benefit to the child.

"If pediatricians around the country adopt and follow these recommendations, the savings to our health care system could be in the millions, given the large number of hospitalized children this would affect," said lead researcher Ricardo Quinonez, MD, FAAP, FHM of the Children's Hospital of San Antonio and Baylor College of Medicine.

In an accompanying review, researchers also outlined the five recommendations adopted by the Society of Hospital Medicine regarding the care of adults. These recommendations include:

  1. Do not place, or leave in place, urinary catheters for incontinence or convenience or monitoring of output for non-critically ill patients.

  2. Do not prescribe medications for stress ulcer prophylaxis to medical inpatients unless at high risk for gastrointestinal complications.

  3. Avoid transfusions of red blood cells for arbitrary hemoglobin or hematocrit thresholds and in the absence of symptoms or active coronary disease, heart failure, or stroke.

  4. Do not order continuous telemetry monitoring outside of the intensive care unit without using a protocol that governs continuation.

  5. Do not perform repetitive complete blood count and chemistry testing in the face of clinical and lab stability.

"These [pediatric and adult] lists are good starting points, and in fact many hospitalist groups, including our own, are using the Society of Hospital Medicine practices as a foundation for our waste reduction efforts," wrote Andrew Auerbach, MD, MPH, and Robert Wachter, MD, of the University of California, San Francsico, in an accompanying editorial. "The next challenge will be translating these recommendations into actionable measures and then clinical practice."


'/>"/>

Contact: Amy Molnar
sciencenewsroom@wiley.com
Wiley
Source:Eurekalert

Related medicine news :

1. International vision and driving experts coming to Detroit
2. Experts Agree Too Much Stress and Too Little Water Are Hidden Causes of Most Disease
3. Heartland Institute Experts Comment on Delay of Obamacare’s Out-of-Pocket Cost Limits
4. Sept. 18 Virtual Conference: Experts to Provide Last-Minute Advice on Exchanges Two Weeks Before Open Enrollment Begins
5. The Experts Expands Leadership and Consulting Teams with New Executives
6. Recovery Experts Turn to Exercise as a Substance Abuse Treatment Aid
7. Skin Rejuvenation Experts Facial Attraction Launch $100 Discount Winter Promotion To Revive Dryness Caused By Cold Weather
8. ATA Seeks Telemedicine, Telehealth and mHealth Experts to Present at Spring Conference in Baltimore
9. Two Industry Experts Discuss Pharmacy Benefit Design on Health Insurance Exchanges in Aug. 1 Webinar
10. Synthetic Vitamin E Market Scrutinized by Industry Experts in New Research Report Available at MarketPublishers.com
11. Three Insurance Exchange Experts Will Detail Outreach and Enrollment Strategies in July 31 Webinar
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... On June 10-11, 2016, A Forever Recovery, ... Festival and World’s Longest Breakfast Table in Battle Creek, MI, where the rehabilitation facility ... home to some of the world’s leading providers of cereal and other breakfast foods. ...
(Date:6/25/2016)... ... 25, 2016 , ... Experts from the American Institutes for ... Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. , AIR ... care planning, healthcare costs and patient and family engagement. , AIR researchers will ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... As a ... Magna Cum Laude and his M.D from the David Geffen School of Medicine at ... returned to Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars ...
(Date:6/24/2016)... ... 24, 2016 , ... Those who have experienced traumatic events may suffer from ... avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid this ... coping following a traumatic event. , Trauma sufferers tend to feel a range of ...
(Date:6/24/2016)... Francisco, CA (PRWEB) , ... June 24, 2016 ... ... CitiDent, is now offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive ... self-ligating Damon brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Dehaier Medical Systems Ltd. (NASDAQ: DHRM ) ... medical devices and wearable sleep respiratory products in ... with Hongyuan Supply Chain Management Co., Ltd. (hereinafter referred ... to develop Dehaier,s new Internet medical technology business. ... Hongyuan Supply Chain,s sales platform to reach Dehaier,s dealers ...
(Date:6/24/2016)... Belgium , June 24, 2016 ... the appointment of Dr. Edward Futcher ... Non-Executive Director, effective June 23, 2016.Dr. Futcher was ... Nominations and Governance Committees.  As a non-executive member ... independent expertise and strategic counsel to VolitionRx in ...
(Date:6/23/2016)... , June 23, 2016 ... "Pharmaceutical Excipients Market by Type (Organic Chemical (Sugar, ... Formulation (Oral, Topical, Coating, Parenteral) - Global Forecast to ... The global pharmaceutical excipients market ... at a CAGR of 6.1% in the forecast period ...
Breaking Medicine Technology: