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Purpose <p>Physicians are estimated to be responsible for more than 50% of national healthcare costs and hold the greatest potential to improve value by orchestrating quality-driven programs to reduce unnecessary practices and variability. A physician’s ability to practice cost-conscious care has been linked to their training, underscoring the importance of integrating cost-conscious practice into training.</p> Methods <p>The High Value Practice Academic Alliance was formed to help advance the value-improvement work of individual institutions through a national organization. We developed a curriculum and mentorship model for trainees throughout the country titled the Future Leaders Program (FLP). Upon entry to FLP, GME physicians completed a baseline self-assessment of their knowledge about costs, payment, and value in healthcare. Over 1&#xa0;year, these physicians participated in structured educational activities related to high-value care (HVC), received mentorship focused on leading a value-based quality improvement (QI) project, and then completed a second self-assessment upon completion of the program.</p> Results <p>Over four academic years (AY17-18 through AY20-21), we had 161 respondents. Most participants report some prior education in healthcare value; however, many had never participated in a QI project. Participants showed variability in their knowledge. After completion of the program, paired sample <i>t</i>-tests demonstrated significant differences in the subscale scores for value knowledge (<i>M</i> =  − 0.63, <i>SD</i> = 0.93), attitudes (<i>M</i> =  − 0.46, <i>SD</i> = 0.45), and skills (<i>M</i> =  − 0.40, <i>SD</i> = 0.71) indicating that participating in a value-focused QI project improved value knowledge, <i>t</i>(160) =  − 9.66,&#xa0;<i>p</i> &lt; .001; attitudes towards high-value care teaching, <i>t</i>(160) =  − 12.48, <i>p</i> &lt; .001; and high-value care practice frequency, <i>t</i>(160) =  − 6.93,&#xa0;<i>p</i> &lt; .001.</p> Conclusions <p>Skills and knowledge are significantly improved after completion of our program, demonstrating that a free, web-based curriculum and tiered mentoring program can be effective in teaching HVC skills and preparing physicians to lead this work.</p>

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High-Value Care Education in the USA: Lessons from a National Value Curriculum for Resident and Fellow Physicians

  • 期刊论文

  • 发表日期：

    2025年1月17日

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  • Priya N. Jain,
  • Christopher J. King,
  • Kiana Johnson,
  • Robert L. Fogerty,
  • Venkata G. Andukuri,
  • Kshitij Thakur,
  • Remus Popa,
  • Kencee K. Graves

摘要

Purpose

Physicians are estimated to be responsible for more than 50% of national healthcare costs and hold the greatest potential to improve value by orchestrating quality-driven programs to reduce unnecessary practices and variability. A physician’s ability to practice cost-conscious care has been linked to their training, underscoring the importance of integrating cost-conscious practice into training.

Methods

The High Value Practice Academic Alliance was formed to help advance the value-improvement work of individual institutions through a national organization. We developed a curriculum and mentorship model for trainees throughout the country titled the Future Leaders Program (FLP). Upon entry to FLP, GME physicians completed a baseline self-assessment of their knowledge about costs, payment, and value in healthcare. Over 1 year, these physicians participated in structured educational activities related to high-value care (HVC), received mentorship focused on leading a value-based quality improvement (QI) project, and then completed a second self-assessment upon completion of the program.

Results

Over four academic years (AY17-18 through AY20-21), we had 161 respondents. Most participants report some prior education in healthcare value; however, many had never participated in a QI project. Participants showed variability in their knowledge. After completion of the program, paired sample t-tests demonstrated significant differences in the subscale scores for value knowledge (M =  − 0.63, SD = 0.93), attitudes (M =  − 0.46, SD = 0.45), and skills (M =  − 0.40, SD = 0.71) indicating that participating in a value-focused QI project improved value knowledge, t(160) =  − 9.66, p < .001; attitudes towards high-value care teaching, t(160) =  − 12.48, p < .001; and high-value care practice frequency, t(160) =  − 6.93, p < .001.

Conclusions

Skills and knowledge are significantly improved after completion of our program, demonstrating that a free, web-based curriculum and tiered mentoring program can be effective in teaching HVC skills and preparing physicians to lead this work.