It is increasingly understood that quality improvement should address both increasing the delivery of high-value care services and decreasing the delivery of services for which the potential for harm is greater than the benefits. And while an issue of quality care, it is also an issue of equity. While there are no differences in the rates of low-value or high-value services delivered by safety net and non–safety net providers, the stakes are higher for vulnerable populations most often served by safety-net providers. The potential for financial, not to mention physical and emotional, harm is higher. It is with this understanding that the MacColl Center for Health Care Innovation at Kaiser Permanente Washington Health Research Institute, with the support of The Robert Wood Johnson Foundation, designed the Safety Net Value Champions Fellowship.
The Safety Net Value Champions Fellowship was created to support clinical champions, particularly in safety-net provider settings, who have the potential to be remarkably effective in addressing overuse by increasing the engagement of providers. By transmitting knowledge effectively, facilitating reflective practice among providers within a clinic setting, and serving as role models of high-value care delivery, clinical champions can be role models for providers, creating a supportive environment in which to do the difficult work of reducing medical overuse—for all populations, and particularly those with fewer resources to access care.
This nine-month program offers six clinical champions training 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. The curriculum includes not only in-person convenings, but also one-on-one mentoring by our faculty as fellows implement projects to reduce overuse in their home institutions during the program. Administrators and health care providers will walk away with the skills and knowledge to change how care is delivered in their setting so that care teams are doing less of what harms and more of what helps patients.