Facilitator's Guide

Rationale for this Module

One of the most significant challenges in many overuse reduction initiatives is finding reliable and valid data on rates of overuse and developing meaningful measures of overuse from that data. Value Champions often find themselves placed at the end of a large queue of data requests from their Health IT department, only to find that the data provided is not useful. In fact, selection of an overuse topic/service to address should always consider the availability of data on the targeted service. 

How to Prepare for this session

This can be a challenging module to prepare for. As with other modules, a good place to start is reading the assignments and making notes about what sections are relevant for the Discussion Questions.  The IHI Open School resource on “Establishing Measures” is also highly recommended to prepare for this class session. It will give you some insights into issues regarding selection of data sources and measures.

Suggested Agenda

    • Welcome and introductions (10 minutes)
    • Discussion of required readings (20 minutes)
    • Small group exercise (15 minutes)
    • Reconvene: Putting it all together (10 minutes)

Probes for discussion questions

    • How might the article by Korenstein et al. in the readings from Learning Module 1 inform you selection of one or more balancing measures?
    • If no ready source of data exists in your health IT systems, what are other ways you might observe or “measure” whether or not your overuse reduction efforts are effective?
    • Have you every used a “run chart” to track a measure over time? What are some practical clinical examples of a run chart? (think about charting a patients temperature over time, or their white blood cell count) How might you use a run chart in your project?


Small Group Exercise

    • Ask the class to read the Case Study on pages 7-8 of the “Working in Concert: A How-To Guide to Reducing Unwanted Variation in Care.”
      • Ask members of the group to work in pairs. Their first assignment is to answer these questions after reading the case study:
        • How was data helpful to them in choosing a clinical topic to address?
        • Why did they present data with the clinicians’ names in the report?
        • How would you react if you were in the room and your name was displayed on a report showing a higher than average rate of ordering a low-value care service?
    • Then, ask them take turns role-playing the scenario presented where one of them is the physician with a high rate of CT orders for abdominal pain and the other is facilitating the conversation. The one role-playing the physician should choose 2 or 3 of the concerns on the top of page 7 and the facilitator should respond to the concern. Then they should reverse the role-play.
    • Re-convene: ask the participants what was the most uncomfortable or awkward moment in their role-play, and why. How would they apply these lessons to their project?
Last modified: Thursday, 15 April 2021, 11:19 AM