The Do No Harm Project at the University of Colorado-Denver was started because founders recognized that healthcare overuse is “an urgent ethical issue,” said co-founder Brandon Combs, M.D., in a webinar hosted by the Lown Institute.
At the core of the initiative is the idea that clinicians should do “as much as possible for the patient [and] as little as possible to the patient,” Combs said.
He distinguishes between more obvious patient harms — malpractice and errors–and what he termed “reasonable overuse,” such as ordering unnecessary tests or procedures, that’s harder to define but can be just has harmful and costly, which is why it’s the focus of the Do No Harm Project.
His best practices for the Do No Harm program include, FierceHealthcare reported:
“Think big, start small. The University of Colorado identified three initial goals in its campaign: recognize harms from overuse, start a conversation about it and change the local culture, Combs said, adding that it’s important for providers to remember that they don’t have to do it all overnight.”
“Find your niche.” The founders focused on clinical vignettes because, he said, “patient stories are very powerful” and can be rallying cries for change.
“Make it stick. One key to UC-Denver’s success was supportive faculty, particularly its chief medical resident, ”who served as both a facilitator and educator for participants….”
”Don’t underestimate your potential.” The Do No Harm Project extended its reach and credibility far beyond what its founders expected by partnering withJAMA Internal Medicine to publish the participants’ vignettes in its “Teachable Moment” series.”
“Measure and celebrate success. ‘If you’re going to take the time, measure the impact to see if it’s important,’ Combs said, adding that it’s also key to share these results as widely as possible so that others can replicate your success.”