|
Value of Care Initiative (VOCI)
In early 1994, Dean Health System (DHS) physicians began working on a challenging new project known as the Value of Care Initiative (VOCI). The mission of this initiative was to improve the value of care provided to our patients. Value is simply defined as the highest quality medical care at the most appropriate cost. The mission of VOCI remains unchanged.
VOCI topics may be suggested by any clinician. Typical topics concern areas of medicine in which there is significant practice variation and lack of adherence to evidence based best practice. A team of physicians who are considered experts in the area of concern review the clinical literature and come to a consensus on best practice which then becomes a VOCI Guideline or Practitioner Alert. Before a guideline or alert is finalized, it is brought by the physicians to colleagues for review and critique, thereby substantially expanding physician input.
All updated or new VOCI Guidelines and Practitioner Alerts are also presented to the DHS Clinical Management Task Force for review and approval prior to publication. As with any clinical guideline or other description of best practice, revisions will be necessary. Teams formulating guidelines will continue to monitor clinical literature and amend their guidelines at least every two years and earlier if needed.
Our definition of guidelines reflects that used by the American Medical Association and the Agency for Health Care Research and Quality. Guidelines are “Systematically developed statements to assist practitioner and patient decisions regarding appropriate health care for specific clinical circumstances.” This definition recognizes guidelines as recommendations for patient management which may identify a particular management strategy or a range of management strategies applicable to the average patient with a particular clinical condition. This definition also recognizes that no single method of providing guidance will be appropriate for all areas of medicine or for all patients. Individual patient differences in the nature of clinical issues, availability of alternative courses of treatment, patient preference, and other factors may call for different approaches.
It should be clearly understood that adherence to these guidelines is voluntary. VOCI guidelines should not be considered inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. These guidelines have not been developed as, nor should they be construed as, absolute standards or minimal levels of care. The ultimate judgment regarding the application of any specific mode of treatment must be made by the physician in light of the individual circumstances presented by the patient. In other words, these guidelines are not intended to replace the clinical judgment of clinicians. It is anticipated that periodic deviation from these guidelines will be a necessary and proper response to individual patient variation and patient preferences with respect to clinical care choices.
lead to an external site |