Following an engaging April 2019 meeting and training in Seattle, along with continued mentoring and skill sharing, our six Safety Net Value Champions have defined and begun work on their topics during their nine-month Taking Action on Overuse fellowships.

Our Safety Net Value Champions are agents of change. Our fellowship trains clinical champions from safety-net settings to be effective at engaging their colleagues to address medical overuse.

Fellows gain skills and knowledge to change how care is delivered in their settings so that care teams are doing less of what harms and more of what helps patients. Our curriculum is based on the Taking Action on Overuse Framework—a roadmap for action and behavior change that leads to reductions in medical overuse—and what we’ve learned from implementing it.

Here are the important issues that our six Fellows are addressing within their own organizations:

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Tackling unnecessary prescribing of over-the-counter medications for common colds and upper respiratory infections in children, from birth to 13 years

Commonly recommended cold medications lack proven effectiveness, and their use could potentially result in physical and financial harm for families encouraged to use them.

Champion:  Elizabeth Vossenkemper, Certified Pediatric Nurse Practitioner at Tri-Cities Community Health

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Decreasing antibiotic use for diabetic food wounds by eliminating antibiotics when not warranted and tailoring antibiotic use for mid-moderate infections

In New Mexico, where diabetes is common, diabetic foot wounds are often overtreated with antibiotics.  This perpetuates antibiotic resistance and creates the potential for a cascade of harmful effects that include prolonged hospital admissions and financial distress in an economically disadvantaged population.

Champion: Leslie Dunlap, Physician Assistant at the University of New Mexico Hospitals

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Addressing overutilization of in-person office visits for post-partum blood pressure checks in mothers who had elevated blood pressures during prenatal care or delivery

In-person office visits to follow-up on elevated blood pressure during labor and delivery can result in unnecessary stress on new mothers and their newborns, and the transportation costs can create economic hardship for some.  We have the technology to remotely monitor blood pressure and vastly improve the experience of care.

Champion:  Lauren Demosthenes, Clinical Assistant Professor, Doctor of Obstetrics and Gynecology at the School of Medicine Greenville at the University of South Carolina

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Reducing the rate of vascular access catheter use and catheter size for prolonged antibiotic infusions

Unnecessary use of vascular access catheters for prolonged antibiotic infusions can lead to catheter-associated deep vein thrombosis (DVT).  This work could help reduce complications, increase opportunities for improvement in antibiotic stewardship, and decrease financial burdens for patients.

Champion:  George Hoke, Associate Professor, Doctor of Internal Medicine at the University of Virginia Health System

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Reducing overuse of opioids for chronic pain by implementing safer prescribing interventions and providing alternative high-value care options

Buffalo is no stranger to the opiod epidemic.  Working directly with the clinicians at the system level, we'll engage patients by informing them of the risks through a new patient agreement and provide non-opioid options for treatment of pain. 

Champion:  Roberto Diaz Del Carpio, Clinical Assistant Professor, Doctor of Internal Medicine at the University of Buffalo Jacobs School of Medicine and Biomedical Sciences

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Appropriate use of imaging for the evaluation of low back pain in the emergency department 

Tests like radiographs and CT scans for chronic low back pain often do not help patients and at times have unintended consequences.  We will implement nationally recognized guidelines in decision-making and deliver more effective treatment strategies for patients with chronic low back pain in the emergency department.

Champion:  Joshua Moskovitz, Physician and Associate Director of Emergency Department Operations at the Jacobi Medical Center at NYC Health + Hospitals

Event Date: 
Mon, 09/30/2019