By 2018, health care expenditures could account for 20 percent of our gross
domestic profit. The increase in medical expenditures threatens to outstrip
both health benefits and the nation’s capacity to pay.
Pediatric hospital care is inherently costly: Children often can’t tell
you what’s wrong, so testing is frequently needed for diagnosis. Clinicians
need flexible, evidence-based standards that improve upon often-obsolete clinical
practice guidelines and narrowly crafted randomized controlled trials to continually
improve care while decreasing overutilization of resources and reducing
In 2008, to address rising health care utilization costs and a lack of evidence-based
data to guide care, the Heart
Center at Children’s Hospital Boston introduced
Standardized Clinical Assessment and Management Plans (SCAMPs), a quality improvement
initiative that collects and analyzes clinical decisions data to standardize
care in a fast-evolving clinical environment. To date, 14 SCAMPs have enrolled
2,600 Children’s patients with cardiac conditions such as arterial
switch operation (ASO), dilated aorta and chest pain.
The SCAMPs initiative has been supported by Children’s Provider-Payor
Quality Initiative, which sees the long-range benefit of accurate, ongoing
assessments and refinements of care standards and utilization.
- Projected one-year cost savings from decreased utilization
of resources in the ASO SCAMP alone is 16.4 percent.
- Five SCAMPs have
already undergone review and modification based on evaluation and data; two
other SCAMPs are currently in review.
- More than 150 patients at other
New England institutions have also been enrolled.
- SCAMPs will begin
institution throughout Children’s by June
More information: childrenshospital.org/reducingcosts