Hospitals and health systems have a responsibility to encourage appropriate and consistent use of health care resources and give caregivers the tools to better communicate with patients about appropriate use.

As part of the AHA’s effort to drive appropriate use of medical resources, the AHA’s Physician Leadership Forum (PLF) has released a series of toolkits or resources that address a “top five” list of hospital-based procedures or interventions that should be reviewed and discussed by a patient and physician before proceeding. Here’s a brief description of each one.

 

Appropriate blood management in inpatient services.  The toolkit is designed to help hospitals and health systems put in effect a patient blood management (PBM) program. The resources include a tool to help senior management, quality leaders and others assess their hospital’s readiness to adopt a formal PMB program, and a patient handout that answers common questions about transfusion and PBM. It was developed with resources from AABB, formerly known as the American Association of Blood Banks.

 

Appropriate antimicrobial stewardship. The toolkit includes resources for hospital leaders, clinicians and patients, starting with a tool developed by the Centers for Disease Control and Prevention (CDC) to help hospitals assess their readiness for optimal antibiotic prescribing and use. It was developed in collaboration with the Association for Professionals in Infection Control and Epidemiology; American Society of Health-System Pharmacists; CDC; Infectious Diseases Society of America; Pediatric Infectious Diseases Society; Society for Healthcare Epidemiology of America and Society of Hospital Medicine.

 

Reducing inpatient admissions for ambulatory-sensitive conditions. These are conditions – like, for example, low back pain, asthma or uncomplicated pneumonia – that could be avoided with adequate primary care. The toolkit includes resources that can help hospitals work to reduce preventable inpatient admissions. Factors contributing to these admissions include a shortage of primary care physicians, ineffective communication between primary care and subspecialist doctors and a lack of patient engagement. The toolkit was developed in partnership with the Agency for Healthcare Research and Quality, American Academy of Family Physicians, American College of Physicians, CDC and National Heart, Lung and Blood Institute.

 

Appropriate use of elective percutaneous coronary intervention. These are procedures that involve the non-surgical widening of the coronary artery for patients with acute heart disease. The toolkit includes quality improvement resources and links to the National Cardiovascular Data Registry for hospitals and health systems; mobile applications, guidelines and clinical evidence for clinicians that help make the care for the appropriate use of elective percutaneous coronary interventions; and information to help patients understand the best use of angioplasty and how to obtain the right tests and treatments. It was developed in collaboration with the American College of Cardiology, American Heart Association and Society for Cardiovascular Angiography and Interventions.

 

Appropriate use of the intensive care unit for imminently terminal illness. The toolkit is designed to help hospital leaders, clinicians and patients align intensive care unit treatment with patient priorities in the context of progressive disease. It includes assessment guides, a palliative care screen, tip sheets, clinical articles and patient resources. The resources were produced in collaboration with the Center to Advance Palliative Care, Coalition to Transform Advanced Care, Education in Palliative and End-of-Life Care, National Hospice and Palliative Care Organization and Society of Critical Care Medicine.

The PLF toolkits grew out of a 2013 AHA white paper on appropriate use of medical resources.

The white paper identified the drivers of health care utilization and its contributing factors, and questions that should be taken up with hospital governing boards. And it recommended a way to move forward that places hospitals at the forefront of innovative change for reducing non-beneficial services while improving health care overall.

The AHA encourages hospital and health system leaders to share the white paper and toolkits with their boards, medical staff and community leaders. Click here to access these resources.