By Brenda Dickinson
Researchers at the U-M are seeking ways to provide better patient care. One way is to develop standardized practice guidelines that work. The problem with practice guidelines is they are easy to write but very difficult to implement and monitor in terms of their effectiveness. The MorCARE project will provide a tool to develop and implement practice guidelines and the Anesthesiology Department has received a $360,000 grant from the Aetna Foundation to develop this concept.
Specifically, this grant will determine the variability in anesthesia care when the practice guidelines are presented at the point of care. Individual anesthesia practitioners will not be required to adhere to any of the practice guidelines but will be asked, by the computer, to document their reasons for not following the guidelines. The investigators expect the reasons for not adhering to the guideline will either be due to patient disease, teaching or research. In those cases where there is no clear guideline, we will do prospective randomized trials to develop the evidence required for producing the guideline.
Researchers at the U-M will also use this information to develop strategies to reduce the variability in clinical practice. This includes devising strategies for implementing a system that provides feedback to practitioners and monitors the practicality of the practice guidelines. The Chair of the Department of Anesthesiology, Kevin Tremper, Ph.D., MD, FRCA developed the concept for these studies. He played a key role in guiding the Principal Investigator, Michael O’Reilly, M.S., M.D. in producing the proposal to Aetna. Co-investigators include Drs. Paul Kazanjian, Norah Naughton and Carmen Green. Acting as consultants are Drs. Alan Tait, Joyce Wahr and Kevin Tremper. Results will be made public beginning late in the year 2000.
The grant was given by Aetna and four leading pharmaceutical companies: The Aetna Foundation, Aetna U.S. Healthcare, Hoechst Marion Roussel, Merck, Schering-Plough Corporation, and SmithKline Beecham. The U-M award is among $6.8 million in outcomes research grants that were awarded to 13 member institutions of the Academic Medicine and Managed Care Forum. Funds were made available through the Quality Care Research Fund, to which Aetna has pledged $15 million in grants over a five-year period, and through the pharmaceutical companies. This is the second year in which grants have been funded through the Forum, with a total of 36 grants and a funding level of nearly $13 million. The grants awarded focus on quality care management and on improving both health care education and measurements for patient satisfaction. Proposals funded by Aetna were submitted to the Forum in several categories, including a general, population-based category, women’s cardiovascular health, and demonstration projects in three areas reflecting Forum work groups: medical education, information systems and technology, and workplace health. Aetna is one of the country’s largest insurance and financial service organizations, with three primary businesses: Aetna U.S. Healthcare, Aetna Retirement Services and Aetna International. Aetna U.S. Healthcare is the nation’s leading health and related benefits organization, with a total health enrollment of nearly 16 million Americans.
The Anesthesiology Department is pleased to receive this support from the Aetna Foundation.