Value Champion

Rationale for the Module

As the title implies, there are so many areas of overuse in most healthcare settings that selecting one service (topic) to address can be challenging. Many Value Champions enter this work with a overused service they want to address. Unfortunately, they have usually not considered the suitability of that topic or service for their first overuse reduction project. They may not have thought through what it might require to address that service, whether or not reducing that service is consistent with current strategic priorities (critical for leadership support), whether there is adequate willingness to consider relinquishing the service, if there is a replacement service, or who in the organization might be adversely impacted by reducing the use of that service (think power and money). The purpose of this module is to STOP and REFLECT on these issues before launching their project.

How to Prepare for this Module

As with other modules, reading the assignments and making note of where in the assigned readings you can find answers to the discussion questions is a good place to start. You should also consider watching the recorded webinar on this topic as it covers many of the learning objectives. There are some additional probe question below to use during the discussion of the questions above. Keeps these handy during the class. For the small group activity, ask the learners to rate on a scale of 1 to 5 how committed they are to a specific overused service. For scores of 3 or less, assign them to the Apples, Oranges, Bananas exercise, those with scores of 4 or 5 should be assigned to the Go-No-Go exercise.

Suggested Agenda

• Welcome and introductions (10 minutes)
• Discussion of required readings (20 minutes)
• Small group exercise (20 minutes)
• Reconvene and debrief (10 minutes)

Small group exercises

Choose one of the following exercises for your group. The “Go-No-Go exercise might be most helpful for participants who have already selected a topic. The “Apples, Oranges, Bananas” exercise might be most helpful for participants who are still in the process of deciding about an overused service to address.

1. Apples, Oranges, Bananas

• Use the “Apples, Oranges and Bananas Exercises Worksheet” for this activity

• Instructions:
  • List 3-5 key stakeholders (column 1 of a table) to engage that would help or hinder your overuse reduction initiative (e.g. health system executive sponsor, division chief, director of health system data, clinical champions, medical assistant supervisor, etc).
  • Describe how your project could benefit each stakeholder if applicable (column 2).
  • Describe how your project could challenge/ hinder (e.g. lose staff time, funding, etc) each stakeholder if applicable (column 3).  (5 minutes)
  • Write down key bullet points that could guide you in how you might initially discuss your project with each stakeholder. Remember to Choose Your Words Wisely (reference: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2536191).
  • Practice role playing with a partner to give your initial pitch (1-2 minutes long) for at least two of the stakeholders you identified who may face challenges due to your project.  Your partner can provide feedback on if the pitch will be a “Go” or “No Go” in partnership for your project.
  • Reflection on the activity back with the larger group.

2.. Go-No-Go Exercise

• Use the “Go-No-Go Exercise Worksheet” for this activity.

• Instructions:
  • List an example of a medical overuse reduction initiative in your institution that you believe could be considered “low hanging fruit” as defined by the Newman-Toker article (row 1 of a table).
  • List an example of a medical overuse reduction initiative in your institution that you believe could be considered “easily juiced” as defined by the Newman-Toker article (row 2 of a table).
  • Complete the second column for each row asking for each example to describe what makes the project either low hanging fruit or easily juiced.
  • Once completed, discuss with a partner.
  • Reflection on the activity back with the larger group.