Value Champion

Module 7: Engaging health care professionals: the Taking Action on Overuse Change Package

The Taking Action on Overuse framework provides a roadmap for action and is accompanied by a change package with suggested key activities to select from when designing an intervention.

Overview

You have selected an area of overuse to address, you’ve engaged with leaders and you have assessed and engaged with your stakeholders. How will you intervene to get your colleagues to do less of what harms and more of what helps patients? When attempting to reduce the use of an overused service, engaging providers, patients and staff in these efforts is often the missing piece of the puzzle. This engagement needs to move individuals from awareness that the potential for harm is greater than benefit, to ownership of the responsibility to change one’s beliefs and behaviors, and then to action at the point of health care delivery. An understanding of what motivates these behaviors, and the cognitive biases that influence those motivators is essential. A walk through the elements of the Taking Action on Overuse action-planning framework, and an exploration of key changes and activities to consider in your efforts to engage colleagues, patients and team members in reducing your targeted overuse topic. The Framework provides a conceptual overview of how successful health care systems have reduced overuse. The Taking Action on Overuse Change Package provides key changes and examples of practical activities you can use to enact those changes.

Learning Objectives

• Understand four intrinsic motivators of clinician behavior based on Max Weber’s typology and give an example of each.
• Describe the core elements within the Taking Action on Overuse framework and explain how these catalysts support conversations that drive behavior change.
• Give examples of key activities that foster and support each component of the Taking Action on Overuse framework.

Reading Assignments

Engaging Physicians in the Health Care Revolution

The Harvard Business Review allows two free article downloads each month.

This article describes four intrinsic motivators that drive clinician behavior. You should consider each motivator as a  ‘lever’ you can pull when designing your interventions and your actions as a clinical value champion.

• Citation: Thomas Lee and Toby Cosgrove: Engaging physicians in the health care revolution.  Harvard Business Review, June 2014.

Creating the Culture for Change

This article, along with the accompanying ‘change package' provides a conceptual overview of how successful health care systems across the U.S. have reduced overused services. It synthesizes the lessons learned into an “action-planning framework” and a ‘change package’ of ideas for actions to reduce overused services.

• Citation: Parchman ML, Henrikson NB, Blasi PR, Buist DS, Penfold R, Austin B, Ganos EH. Taking action on overuse: Creating the culture for change. Healthc (Amst). 2017 Dec;5(4):199-203. doi: 10.1016/j.hjdsi.2016.10.005. Epub 2016 Nov 10. PMID: 27840099.

Creating Value in Health by Understanding and Overcoming Resistance to De-innovation

The authors give examples of three types of cognitive bias that may influence efforts to de-implement low-value care services. They then describe how awareness of these biases should inform our selection of strategies to engage others in decreasing their use. 

• Citation: Ubel PA, Asch DA. Creating value in health by understanding and overcoming resistance to de-innovation. Health Affairs. 2015;34(2):239-244.