Implementation of a Resident-Led High Value Care Bootcamp to Teach Core Skills in Value-Based Care Delivery

From the 2019 HVPAA National Conference

Dr. Michelle Knees (University of Colorado), Dr. Jason John (University of Colorado), Dr. Sam Porter (University of Colorado), Dr. Byron Crowe (University of Colorado)

Background

Resident physician interest in high-value care delivery is growing, but there are limited venues for residents to receive formal training on principles of high-value care. Although residency programs typically offer training on the related topics of quality improvement and patient safety, the infrastructure for educating on high-value care is less mature while demand is growing.

Objective

To address the demand for content and community around value-based care redesign, we designed and implemented a resident-led, faculty-supported High Value Care Bootcamp at the University of Colorado in spring 2019.

Methods

The High-Value Care Bootcamp is a 7-week program introducing residents from across specialties to core principles and practice of high-value care. The curriculum consists of four in-person sessions in weeks 1, 3, 5 and 7 and three independent learning sessions in weeks 2, 4 and 6. Sessions are designed to be interactive and discussion-based among trainees and faculty guides, with faculty drawn from a diverse pool of interests to promote multiple viewpoints and career pathways. In-person events are held at local co-working spaces, food halls and healthcare incubators to drive engagement by creating a more casual and conversational atmosphere for attendees.

The four in-person sessions introduce major concepts in value-based care delivery and culminate in a final sessions focusing on career opportunities. The first session, High Value Care and Payment Models, introduces trainees to the various mechanisms and incentive structures that define value in both the current healthcare system and new care models. The second session, Architecture of High Value Care, focuses on the HVPAA “Pillars of High Value Care” as a framework for conceptualizing areas for value-based intervention. The third session, Social Determinants of Health, broadens the framework of value to encompass non-clinical factors and their impact on health and value. The fourth and final session, “Careers in High Value Care”, brings in faculty to describe their pathways to engaging in high-value care work across the institution and community and opens up discussion on how trainees can begin to build experience and credibility in leading work on value. Between each in-person session, participants are emailed curated landmark articles and resources for independent learning. After each in-person session, participants are asked to fill out a brief survey to elicit feedback on the event and their learning.

Results

Participation at each sessions ranged from 10-18 residents and 3-5 faculty. In post-session surveys, 100% of residents agreed or strongly agreed that they gained meaningful knowledge and insight (n=20) and 100% would recommend future sessions to colleagues (n=23). Unstructured feedback emphasized the value of small-group learning and the discussion-based format.

Conclusions

The High-Value Care Bootcamp was well-received in its pilot year with overall agreement that the sessions improved knowledge and were enjoyable. The Bootcamp format can serve as a model for other institutions seeking to introduce and engage residents in high-value care concepts.

Clinical Implications

Engaging trainees in the principles and practice of high-value care can introduce useful practice-changing frameworks that promote value as a core component of physician practice. Moreover, exposing trainees to relevant career paths within the high-value care landscape with examples from faculty guides can introduce young physicians to new ways to contribute to healthcare redesign.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

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