Teaching and practicing cost-awareness in the intensive care unit: a TARGET to aim for.
Intensive care is one of the main contributors to rising inpatient hospital costs due to frequent use of expensive diagnostics and therapies. With successful track records of team- and protocol-based care, intensive care units are ideal sites to take the lead in reducing overuse and misuse of diagnostic tests and prescribing. We offer a framework for practicing and teaching cost-awareness in the intensive care unit based on the acronym TARGET. The components of the care are as follows: Talk to patients about their preferences for care, Ask for outside tests, avoid Routine and/or Repeated tests, prescribe Generic medications, Educate about costs, and Transfuse appropriately.
Harvard Medical School; The Commonwealth Fund. Electronic address: manstey@bidmc.harvard.edu.
Matthew H R
MH
Anstey
American College of Physicians, 190 N Independence Mall West, Philadelphia, PA 19106. Electronic address: sweinberger@acponline.org.
Steven E
SE
Weinberger
Carl J. Shapiro Institute for Education & Research, Beth Israel Deaconess Medical Center, KSB23, 330 Brookline Ave, Boston, MA 02215. Electronic address: dhrobert@bidmc.harvard.edu.
David H
DH
Roberts
D001364:Awareness; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data; D002985:Clinical Protocols; D019937:Diagnostic Techniques and Procedures; D016568:Drugs, Generic / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D007362:Intensive Care Units / Q000191:economics*; D010820:Physicians
D016568:Drugs, Generic
Clinical competence; Economics; Health care costs; Intensive care; Medical education