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Establishing Superior Benchmarks of Care in Clinical Practice A Proposal to Drive Achievable Health Care Value

Kavita Parikh, MD, MSHS1; Shantanu Agrawal, MD, MPhil2
[+] Author Affiliations
1Department of Pediatrics, Children’s National Health System, The George Washington School of Medicine, Washington, DC
2Center for Program Integrity, Centers for Medicare and Medicaid Services, Washington, DC
JAMA Pediatr. 2015;169(4):301-302. doi:10.1001/jamapediatrics.2014.3580.
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This Viewpoint supports establishing superior benchmarks of care in clinical practice. Establishing achievable excellence is an approach that encourages improvement while not demanding unrealistic or potentially adverse outcomes.

Value-driven care is a central theme across medicine in the current era of health care reform. Numerous factors are working to decrease unwarranted variability in care that drives up costs without adding value. For example, asthma, bronchiolitis, and pneumonia are leading causes of pediatric admissions with good data available to inform optimal management, and despite this, tremendous variation of care has been well documented.1 Clinical practice guidelines (CPGs), systematically developed statements that guide decision making, are intended to streamline care and reduce unwarranted variation. It is not surprising that major national organizations such as the American Academy of Pediatrics, the National Heart, Lung, and Blood Institute, and the Infectious Diseases Society of America have developed evidence- and consensus-based CPGs for the management of bronchiolitis, asthma, and pneumonia, respectively.24 What may be surprising is that, despite the availability of national CPGs for several years for these conditions, wide variation in their management persists across hospitals in the United States, leading to excess resource utilization and cost of care.1

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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