Six of the nation’s leading health care systems today announced a first-of-its-kind collaboration to improve health care quality while reducing costs.Dartmouth-Hitchcock, Cleveland Clinic, Denver Health, Geisinger Health System, Intermountain Healthcare, and Mayo Clinic will join The Dartmouth Institute for Health Policy and Clinical Practice to share data on outcomes, quality, and costs across a range of common and costly conditions and treatments. The group will determine best practices for delivering care for these conditions and will rapidly disseminate actionable recommendations to providers and health systems across the United States. In addition to achieving better quality and outcomes, the Collaborative intends to improve the efficiency of standard clinical care delivery to reduce the per capita cost in these conditions and to keep costs in pace with the consumer price index.The Collaborative will initially focus on eight conditions and treatments for which costs have been increasing rapidly in recent years and for which there are wide variations in quality and outcomes across the country. The conditions and treatments will be: knee replacement, diabetes, heart failure, asthma, weight loss surgery, labor and delivery, spine surgery, and depression, which together amount to hundreds of billions of dollars in direct medical costs each year.‘Increasing the value of the health care we receive, by improving the measurable outcomes and reducing the cost for delivery, is the goal of accountable health care organizations,’ said Thomas A. Colacchio, MD, president of Dartmouth-Hitchcock Health and a member of the executive committee of the new collaborative. ‘While a number of different collaborations between our institutions have been in place for some time, this particular initiative is an important step in generating and sharing quality and cost information at a sufficient level to more rapidly produce a significant impact on the lives of many patients as we work to achieve the healthiest population possible.’The six health care systems, with a combined patient population of more than 10 million people, will share data on outcomes and clinical protocols for the selected conditions and treatments to arrive at optimal care models which can then be implemented by many other health care systems. The Collaborative aims to see these best practices replicated across the country. The Dartmouth Institute will coordinate data sharing and analysis, and report results back to the Collaborative members to inform development of best practices. The Dartmouth Institute has twenty years of experience analyzing Medicare claims data and disseminating the findings. This same expertise will be applied to the work of the Collaborative.‘There is broad support from other health care systems across the country who want to participate in the work of the Collaborative,’ said Dr. James Weinstein, Director of The Dartmouth Institute. ‘It would be enormously valuable to have the broadest geographic and demographic representation in the sharing of outcomes and experience.’The Collaborative will first analyze Total Knee Replacement, a procedure that is performed more than 300,000 times a year in the U.S., with a cost that ranges on average from $16,000 to $24,000 per surgery. Simultaneously, Collaborative partners will build the metrics to study the care of the other selected conditions at their centers and arrive at best practices. Work to define best practices in diabetes and heart failure care will begin early in 2011.‘If we know that the treatment path for diabetes at one institution results in better clinical outcomes, higher patient satisfaction, and lower overall costs, then there is knowledge to be shared and replicated in other institutions’ said Dr. Robert Nesse, Chief Executive Officer of Mayo Clinic Health System and member of Mayo Clinic’s Board of Trustees. ‘We need to learn from each other and put systems in place that ensure that every patient gets the very best, most appropriate care, every time.’Developing models to reduce cost, while improving quality, is only part of the equation. An equally important goal is to impact the clinical care of patients across the country by disseminating these models quickly and working with providers and health systems to adapt them to local conditions. ‘In my view, the most critical piece of this initiative is the transfer of knowledge to other health systems,’ said Dr. Glenn Steele, President and Chief Executive Officer of the Geisinger Health System. ‘We need to aggressively implement a rapid learning network to disseminate our work and assist other systems in implementing these best practices, especially the highest cost systems.’Through The Dartmouth Institute, the Collaborative will also draw on the work of the Center for Health Care Delivery Science, established at Dartmouth College in May, 2010 and dedicated to research, education, collaboration, implementation, and public outreach to improve health and health care for patients, their families, providers, and populations.Source: Dartmouth-Hitchcock. 12.15.2010###
After beating the Washington Huskies in game one of the weekend’s series, the Trojans lost the next two games to bring their record to 13-11 on the year.Sophomore Lars Nootbaar’s struggles at the plate continued this weekend against Washington. Austin Paik | Daily TrojanThe Trojans took game one thanks to a clutch home run by redshirt junior third baseman Angelo Armenta in the bottom of the eighth inning to seal the game by a score of 1-0. The Trojans, however, were not as fortunate in game two, losing 5-2. The Trojans were off to an early lead in the first inning when junior first baseman Dillon Paulson hit a 2-run double.However, the Huskies were able to tie the score in the second inning and get 2 runs on the board courtesy of RBIs from freshman outfielder Braiden Ward and freshman second baseman Noah Hsue.The game was tied 2-2 until the top of the fifth inning when Washington senior shortstop Levi Jordan hit a double down the leftfield line off of junior pitcher Solomon Bates to to take the game to 3-2. The game was then killed off in the seventh inning after senior designated hitter Joe Wainhouse hit a 2-run single to put the game out of reach 5-2.After their early lead, the Trojans had a hard time getting the bats going. They only managed to get four more hits the rest of the game.“We jumped early and I thought for his first start Solomon pitched fine,” head coach Dan Hubbs said after game two. “You know they answered back and did a nice job.”Sophomore outfielder Matthew Acosta and junior outfielder Lars Nootbaar played in new positions during game two. Acosta, who usually plays in center field, played in right Friday night. And Nootbaar, who usually plays in left field, played in center.“The switch is more determined on the other outfielder,” Hubbs said. “We decided to put Dubb in the outfield today and get [John Thomas] in the lineup. And he’s better suited for left field and Matthew can play either equally well, and Lars can play left and center equally well, so it was more predicated on that third outfielder than anything else.”Game three ended like game two as the Trojans lost 9-5 on Saturday despite an early lead in the first. Paulson once again got the scoring started for the Trojans as he hit a 3-run homer into right field scoring in junior second baseman Brandon Perez and Nootbaar.However, as they did in game two, the Huskies responded by putting up runs in the second inning. The Huskies scored four runs in the second inning to take the score to 4-3. The Trojans then scored one more run in the fifth inning courtesy of an RBI from Nootbaar to tie the game at 4 runs a piece. In the sixth, the Trojans retook the lead thanks to an RBI from Perez putting the Trojans up 5-4 with three innings left to play.The Trojans have relied heavily on their bullpen all season as it is one of the best parts of their team, but the bullpen gave up 5 runs in the seventh and eighth, ending the game in a loss.The Trojans also uncharacteristically made seven errors in their series against the Huskies this weekend. Prior to the series, the Trojans led the nation in fielding percentage and defending, only making 10 errors the whole year. Earlier in the season, Hubbs mentioned how this team is built around its defense and its bullpen.While Bushor has been playing exceptionally well at shortstop this season, Hubbs seemed excited about the comeback of freshman shortstop Ben Ramirez who returned for game three with a walk and a strikeout.“Well, it would be hard for us to want to move Chase off of shortstop,” Hubbs said of fitting Ramirez and Bushor into the team. “It doesn’t mean that Ben won’t be in the lineup somewhere. Or it means that Chase can play third and move over, or he can play second. I mean there’s a lot of things that we can do, or Ben can play DH. I mean there’s a ton of ways to get him into the lineup.”The Trojans will hope to return to winning ways Tuesday when they play UC Santa Barbara.