How are hospitals measuring and reducing low-value care?

By Judith Garber | November 10, 2021

Low-value care in hospitals is an immense patient safety issue. Every 80 seconds, a hospital in the US delivers a low-value test or procedure to a Medicare patient.

How can hospitals and policymakers better measure overuse and reduce overuse in hospitals, and what role can rankings play? On November 3, US News & World Report hosted an event on the topic featuring overuse experts: Harvard Medical School researcher Dr. Ishani Ganguli, Dr. Aaron George of Meritus Health, and Lown Institute president Dr. Vikas Saini.

Watch the video recording of the event to see the discussion on a variety of topics, including:

How can “cascades” started by low-value tests harm patients?
How do we incorporate patient preferences into overuse metrics?
What are the advantages and disadvantages of using claims data to measure hospital overuse?
How do we address concern from underresourced communities that “doing less” will further reduce their access to care?
Where does measurement of low-value care need to move in the future?

And check out our live tweet threads for some of the highlights and best quotes from the event!

We have to look not only at clinical guidelines but patient preferences. If a patient doesn't want a surgery because they're 95, who's to say they're wrong? @DrVikasSaini
— Lown Institute (@lowninstitute) November 3, 2021

"We need to flip the paradigm from 'Am I doing the right thing?' but 'Am I not doing the wrong thing?' – Dr. Aaron George, Meritus health
— Lown Institute (@lowninstitute) November 3, 2021

Patients may have good reasons to distrust the medical system, esp. if it there are concerns about denying care. "It's not about saying no, it's about saying yes with a different answer." — @DrVikasSaini
— Lown Institute (@lowninstitute) November 3, 2021

To eliminate medication overload, serious cultural, educational, and policy changes are needed. This action plan offers recommendations for policymakers, health care institutions, clinicians, and patients across five key categories to reduce harm from multiple medication use. Suggested Citation: Eliminating medication overload: A national action plan. Working Group on Medication Overload. Brookline, MA: The Lown Institute, 2020. DOI: https://doi.org/10.46241/LI.YLBW4885

Pharmaceutical marketing is a significant factor in the growing public health crisis of medication overload, which puts millions of older adults at risk of preventable harm and premature death. This issue brief provides recommendations to reduce pharmaceutical industry influence by limiting pharma sales rep visits to clinicians and direct-to-consumer advertising.

This issue brief provides recommendations for clinical practice guidelines and electronic health records that would give clinicians the information they need to appropriately prescribe and deprescribe.