Journal of the American College of Radiology : JACR
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Bundled payment (BP) is defined as a single aggregate payment for all health care services for clinically defined episodes of care. Some results suggest that transitioning from a fee-for-service model to BP resulted in a <10% decline in spending and a 5% to 15% decrease in the utilization of services in the bundle. However, future BPs will need to account for how individual providers will be compensated for their services, and acceptance of BP as a viable health care payment model will depend on the ability of payers and providers to collaborate in a new way to address several operational and implementation challenges.
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In this review article, the authors provide a detailed series of guidelines for effectively performing root-cause analysis (RCA) and health failure mode and effect analysis (HFMEA). RCA is a retrospective approach used to ascertain the "root cause" of a problem that has already occurred, whereas HFMEA is a prospective risk assessment tool whose aim is to recognize risks to patient safety. ⋯ The principles and techniques provided here should allow reviewers to better understand the features of RCA and HFMEA and how to apply these processes appropriately. These principles include how to organize a team, identify root causes, seed out proximate causes, graphically describe the process, conduct a hazard analysis, and develop and implement potential action plans.
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To measure the impact of 1-year interventional fellowship training on fluoroscopic time and contrast media utilization in uterine artery embolization (UAE). ⋯ A significant (P < .05) training effect that is clinically relevant was demonstrated over the course of a yearlong interventional radiology fellowship program in performance of a standardized protocol for UAE. This data supports fellowship training as a basis for UAE credentialing and privileging.