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###
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Press Association They all responded to the challenge superbly on Saturday as the Barclays Premier League leaders thrashed Bournemouth 5-1 at the Etihad Stadium. Sterling scored a hat-trick, Bony grabbed the other two and De Bruyne was influential throughout. De Bruyne said: “More people will look at us because we have lost two great players on the attacking front, but I think the other ones are really good players. “Maybe we don’t have the experience of the other ones but I think we are doing really well together and the more games we will get the more we will know each other and hopefully the better we will do. “It is always a blow when you miss them but we need to maintain our level and try to win without them. “It is not an excuse to say at the Etihad we may lose four games because they are not there. If you want to win titles you have to do with the players what you have. Sometimes it is maybe more difficult but you have to try to win these games.” Another player who might have been asked to step up in such circumstances is Samir Nasri but the Frenchman experienced discomfort on his return from a hamstring injury against Bournemouth. The 28-year-old replaced De Bruyne in the 62nd minute but was troubled in the latter stages and only played until the end because City had used all their substitutes. He now looks doubtful for Wednesday’s Champions League clash with Sevilla. Manager Manuel Pellegrini said: “Nasri had a problem with his hamstring. I think it will be very difficult for him (to play Wednesday). “Unfortunately we knew that he was feeling something after we made the third change, but he didn’t run too much. He stayed in the middle so we’ll see in the next day what happens with him.” City’s most established attacking duo were both injured in the recent international break with star striker Aguero set to be out for at least a month and playmaker Silva a fortnight. The pressure to deliver up front has therefore shifted to the likes of De Bruyne, Raheem Sterling and Wilfried Bony – a trio signed for close to a combined £130million over the past year. Kevin de Bruyne accepts there can be no excuses if Manchester City slip up in the absences of Sergio Aguero and David Silva.
When brought before Chief Magistrate Ann McLennan on Friday at the Georgetown Magistrates’ Courts, 47-year-old Ewart Darlington readily admitted to droving motor lorry, GWW 806 in a manner dangerous to the public.The incident occurred as recent as December 22, 2017, reportedly at Friendship on the East Bank of Demerara.As such, Darlington was fined $50,000 with an option to spend three months in prison if he did not pay the fine. His licence was also suspended for a three-month period.According to the prosecution’s case, Darlington was driving on the western carriageway proceeding North along the East Bank Public Road at a fast rate whilst the President’s vehicle was leading the fleet headed in the opposite direction.Police Prosecutor Arvin Moore contended that Darlinston, who in apparent haste, had attempted to overtake another vehicle, found himself in the convoy’s path. Luckily, the President’s driver’s swerved just in time to avoid a head on collision.Notwithstanding Police’s claims that the fleet sounded sirens, the accused claimed that he did not hear such as his windows were up while it poured heavily.Contrary to Police facts, Darlington said he swerved to avoid a collision with a stationary vehicle in his way but ended up in another lane. He nonetheless accepted responsibility and was penalised accordingly.