Measuring high-value care practices

Tool addresses important educational gap


Because health care in the United States is extremely expensive, it’s driving an increased focus on high-value care (HVC), said Carolyn D. Sy, MD. And, she added, while hospitalists and other physicians are the ones responsible for translating HVC from formalized settings (lectures, modules, etc.) to the bedside, there are few instruments designed to measure the success of HVC practices.

So Dr. Sy, director of the University of Washington Medical Center Hospital Medicine Service in Seattle and her colleagues developed an HVC Rounding Tool, which allows users to empirically assess the discussion of HVC topics at the bedside. They divided 10 HVC topics into three domains (quality, cost, patient values) to create an observational tool and tested its validity.

“It addresses an important educational gap in translating HVC from theoretical knowledge to bedside practice,” she said.

The tool is designed to capture multidisciplinary participation: involvement from faculty, fellows or trainees, nurses, pharmacists, families, and other members of the health care team.

It has multidisciplinary benefits too. “The HVC Rounding Tool provides an opportunity for faculty development through peer observation and feedback on the integration and role modeling of HVC at the bedside,” Dr. Sy said. “It also is an instrument to help assess the educational efficacy of formal HVC curriculum and translation into bedside practice. Lastly, it is a tool that could be used to measure the relationship between HVC behaviors and actual patient outcomes, such as length of stay, readmissions, and cost of hospitalization – a feature with increasing importance given our move towards value-based health care.”


1. Sy CD et al. The development and validation of a high-value care rounding tool using the Delphi method. J Hosp Med. 2017;12(suppl 2). Accessed Oct 10, 2017.

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