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J Crit Care. 2014 Feb;29(1):107-11. doi: 10.1016/j.jcrc.2013.08.007. Epub 2013 Sep 24.

Teaching and practicing cost-awareness in the intensive care unit: a TARGET to aim for.

Author information

1
Harvard Medical School; The Commonwealth Fund. Electronic address: manstey@bidmc.harvard.edu.
2
American College of Physicians, 190 N Independence Mall West, Philadelphia, PA 19106. Electronic address: sweinberger@acponline.org.
3
Carl J. Shapiro Institute for Education & Research, Beth Israel Deaconess Medical Center, KSB23, 330 Brookline Ave, Boston, MA 02215. Electronic address: dhrobert@bidmc.harvard.edu.

Abstract

Intensive care is one of the main contributors to rising inpatient hospital costs due to frequent use of expensive diagnostics and therapies. With successful track records of team- and protocol-based care, intensive care units are ideal sites to take the lead in reducing overuse and misuse of diagnostic tests and prescribing. We offer a framework for practicing and teaching cost-awareness in the intensive care unit based on the acronym TARGET. The components of the care are as follows: Talk to patients about their preferences for care, Ask for outside tests, avoid Routine and/or Repeated tests, prescribe Generic medications, Educate about costs, and Transfuse appropriately.

KEYWORDS:

Clinical competence; Economics; Health care costs; Intensive care; Medical education

PMID:
24075293
DOI:
10.1016/j.jcrc.2013.08.007
[Indexed for MEDLINE]
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