Background: Regardless of specialty or discipline, healthcare professionals are tasked with addressing high value care (HVC). It is therefore crucial that hospitalists and other members of the interprofessional team have training in addressing HVC, specifically around education and incorporating HVC into clinical practice and health systems improvement activities.
Purpose: We developed a longitudinal curriculum at a large academic medical center designed for faculty and staff to teach high value care. “Teaching to Provide High Value Care” was offered twice a year in 2018 as a 3-hour workshop in the Schools of Medicine, Pharmacy, Nursing, Physical Therapy and Dentistry. The objectives were to 1) identify high value care (HVC) domains and competencies pertaining to clinical practice, 2) incorporate HVC into current and future health system improvement initiatives and 3) develop a HVC-focused teaching script for learners, peers and patients.
Description: All faculty and staff at the institution and affiliated hospitals were invited via email to attend a 3-hour CME workshop, offered twice a year, in April 2018 and November 2018. During the 3-hour workshop participants completed several exercises including: (1) an introduction to HVC, including associated domains and competencies and examples of how to link these to teaching methods; (2) strategies to incorporate HVC into health system improvement activities, using tools and frameworks including Choosing Wisely and; (3) develop “teachable moments” scripts for learners, colleagues or patients to use in clinical practice. Participants were then contacted at 3-month, 6-month and 12-month intervals by the curriculum directors with the expectation to follow up and identify their progress, barriers to implementation and next steps. All participants were added to an electronic community dashboard with resources and support. Two groups of participants attended the workshops, including 11 faculty and 2 fellows, representing the Schools of Medicine, Pharmacy and Nursing. Participants rated the workshop highly including quality of teaching (mean 5.0, Likert scale 1-5, 1=poor, 5=excellent) and likelihood to make change in teaching/professional practice (mean 4.89, Likert scale 1-5). A identified barrier to implementing change was time. Participants commented that the small group exercises were valuable in creating a larger HVC community. All participants agreed that they acquired skills they would apply toward direct patient care, health systems improvement, medical education and in their role as HVC stewards at their clinical sites.
Conclusions: This “train the trainer” curriculum combined HVC concepts and principles into practical applications for clinical practice and education. The success of the curriculum included explicit expectations, follow up and support for participants to continue their HVC work after the workshop as HVC stewards with the goals of improving patient care and educating learners, peers and patients in their own clinical practice.