Surgical site infection (SSI) is recognized as a focus area by the Centers for Medicare and Medicaid Services, the Joint Commission, the Institute for Healthcare Improvement, and the Institute of Medicine. An estimated 47% to 84% of SSIs present after discharge from the hospital or ambulatory care facility and, as a result, go undetected by standard SSI surveillance programs. Evidence-based processes and practices that are known to reduce the incidence of SSIs tend to be underused in routine practice. This article describes a multistakeholder process used to develop an educational initiative to raise awareness of best practices to reduce SSIs. The goal was to create a patient-centric educational initiative that involved an active partnership among all stakeholders-medical professional organizations, hospitals/health systems, health insurers, employers and other purchasers, and consumers/patients-to provide the climate necessary to create and sustain a culture of safety.
When given the opportunity to become actively involved in the decision-making process, patients can positively impact their health outcomes. Understanding how to empower patients to become informed consumers of health care services is an important strategy for addressing disparities and variability in care. Patient credentialing identifies people who have a certain diagnosis and have achieved certain levels of competency in understanding and managing their disease. Patient credentialing was developed to meet 3 core purposes: (1) enhance patient engagement by increasing personal accountability for health outcomes, (2) create a mass customization strategy for providers to deliver high-quality, patient-centered collaborative care, and (3) provide payers with a foundation for properly aligning health benefit incentives. The Patient Self-Management Credential for Diabetes, a first-of-its-kind, psychometrically validated tool, has been deployed within 3 practice-based research initiatives as a component of innovative diabetes care. Results from these projects show improved clinical outcomes, reduced health care costs, and a relationship between credential achievement levels and clinical markers of diabetes. Implementing patient credentialing as part of collaborative care delivered within various settings across the health care system may be an effective way to reduce disparities, improve access to care and appropriate treatments, incentivize patient engagement in managing their health, and expend time and resources in a customized way to meet individual needs.
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