Louisville Drug Abuse: Data Driven Decisions

Data driven decision-making seems to be a hot topic in healthcare today. Actually, it is a process that manufacturers have used a long time. The Toyota Quality process is built upon data; it is one reason they are the leading maker of quality auto products. Using this concept in healthcare will lead to improved outcomes both for patients and providers. It does take a focused effort to use such an approach.

Let me first illustrate two situations where providers either chose to ignore evidence or had not collected evidence and were making errors because of this. In the report of research on alcohol and primary care physician interaction, titled “How Primary Care Physicians Talk to Patients About Alcohol,” it was noted that 29 patients told their physicians that they were either abusing alcohol or thought they were addicted to alcohol. In only one case did the physician follow through with a discussion about the behavior of the patient and make a recommendation about changing habits. Clearly the physicians were ignoring evidence of behavior with serious consequences. From a Columbia University study of the impact of alcohol and other drugs on the Medicare system it was stated that “Nearly one out of every four dollars Medicare spends on inpatient hospital care, and one out of every five Medicare hospital admissions, are attributable to substance abuse. From cancer to stroke and heart disease, from respiratory infections to injuries and accidents, the use and abuse of cigarettes, alcohol, pills and drugs is a major cause of many diseases that eventually result in hospitalizations for which Medicare pays.” Detection of alcohol and abuse is fairly simple with short screening questionnaires available on the internet.

In the article “Changing Physician Practice Behavior” in the Journal of Family Practice it was stated that 36% of all physicians fail to notify their patients of abnormal test results. The failure to do so can have dire consequences. This is a good illustration of practices failing to gather data about patterns of behavior. Perhaps you are aware of such an occasional lapse in your practice but don’t think it is a serious problem. To be sure, I suggest that you collect a random sample of patient charts in which either preventive tests or diagnostic tests presented abnormal results. Then, find the percent in which patients were not notified. If the percent is too high in your opinion then put in place a process to prevent such mistakes and regularly check on its effectiveness.

Now let me illustrate two situations where data is used to drive decisions. I happen to be involved in both and have seen the positive results first hand. The first involves the alignment of prevention services in the area of alcohol and other drugs. Under the direction of Community Systems Investments International of Louisville, Kentucky several organizations in Kent County Michigan are working to prevent duplication of services and making sure they are delivering the most effective prevention services possible to the right populations. At the root of all of their efforts is a strong emphasis on data collection to drive all decisions. The end result should be a coalition that is more effective in the prevention of abuse and misuse of alcohol and other drugs.

Another program (ALERT Lab) with which I work collects data annually at Grand Valley State University to measure the use of alcohol and other drugs (AOD) by campus students and the consequences of misuse of these. The data collected is used to drive a campaign which corrects misperceptions of students in regard to AOD issues. The campaign has been very effective; in fact by the use of such data the ALERT Labs has increased the percentage of students who either drink moderately or abstain from 63% to 72%. This is quite remarkable since national statistics show that the abuse of AOD substances is much higher than this in colleges nationwide.

If you are not already collecting data to measure the effectiveness of your programs and processes I strongly suggest you do. You may be surprised when you do. Our intuition and guesses about the effectiveness of processes and programs are often widely off the mark, due to prejudices and poor estimation skills. I know that it can be difficult to first find what to measure, especially in prevention services. I believe that if you convene a group of representatives involved in any process that you want to measure that you will be able to find good variables to measure. For instance, in prevention services you might want to measure whether providers are consistently using proven risk measuring screenings. Summarily, find variables to measure, find baseline measures, design improvements, and then monitor and audit your new designs.

BC-AP Sports Digest

Filed under: Louisville Drug Abuse

LOUISVILLE, Ky. – RAC–Horse Racing-Drugs. By Bruce Schreiner. Sent. ATHENS, Greece – Time to get out the cameras: Britain's most photogenic man will be bringing the Olympic flame back from Greece. David Beckham is joining officials at a handover …
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UPI NewsTrack Sports

Filed under: Louisville Drug Abuse

Ex-Kentucky player charged with sex abuse … FSU weighs possible move to Big 12 … Hayden, fishing bait expert, dies at 78 … Horseman Peter Fuller dies at 89 … Sports news from United Press International. LEXINGTON, Ky., May 15 (UPI) — A former …
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The Most impactful Kentucky Wildcat Basketball Players (1981-82 to present …

Filed under: Louisville Drug Abuse

Minniefield has admitted to smoking marijuana the night before Kentucky's loss to Louisville in the 1983 Mideast Regional Final and admits drugs may have affected his play. Regardless, Minniefields numbers at UK must be recognized.
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