We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Viewpoint |

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.
Text Size: A A A
Published online


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

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
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.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

2 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
Distributions of Test Results Illustrate the Spectrum Problem

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed