TRANSFORMING HEALTHCARE Development of a Hospital-Based Program Focused on Improving Healthcare Value

sure to improve the quality of care they deliver while simul-taneously decreasing healthcare costs. Although hospitals and physicians are beginning to implement initiatives target-ing this new goal of healthcare value, few of them have a well-developed infrastructure to support this work. METHODS: In March 2012, we launched a high-value care (HVC) program within the Division of Hospital Medicine at the University of California, San Francisco. The HVC pro-gram is co-led by a physician and the division’s administra-tor, and includes other hospitalists, resident physicians, pharmacists, and administrators. The program aims to (1) use financial and clinical data to identify areas with clear evidence of waste in the hospital, (2) promote evidence-based interventions that improve both quality of care and value, and (3) pair interventions with evidence-based cost awareness education to drive culture change. RESULTS: We identified 6 ongoing projects during our first year. Preliminary data for our inaugural projects are encour-aging. One initiative, which targeted decreasing nebulizer use on a high-acuity medical floor (often using metered-dose inhalers instead) led to a decrease in rates of more than 50%. CONCLUSIONS: The HVC program is proving to be a suc-cessful mechanism to promote improved healthcare value and clinician engagement. Journal of Hospital Medicine 2014;000:000–000.VC 2014 Society of Hospital Medicine With a United States medical system that spends as much as $750 billion each year on care that does not result in improved health outcomes,1 many policy ini-tiatives, including the Centers for Medicare and Med-icaid Services ’ Value-Based Purchasing program, seek to realign hospitals ’ financial incentives from a focus on production to one on value (quality divided by cost).2,3 Professional organizations have now deemed resource stewardship an ethical responsibility for pro-fessionalism,4,5 and campaigns such as the American Board of Internal Medicine (ABIM) Foundation’