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A national survey of approximately 4,000 adults who live in households with firearms found that fewer than 10 percent have ever discussed firearm safety with a clinician (12% of those with children, 5% of those without). When conversations occurred, the most common advice given across all clinical settings was to lock all household firearms. A brief report is published in
Annals of Internal Medicine.
Researchers from Northeastern, Harvard, and Quinnipiac Universities analyzed data from the 2019 National Firearms Survey, conducted online from July to August 2019. Adults living in homes with firearms were asked if a physician or other health care provider ever spoke to them about firearm safety. If yes, the participants were asked where the discussions occurred and whether the patient was an adult or child. They were also asked about the advice given.
A lead author, Peter Pronovost, MD, PhD, Chief Quality and Clinical Transformation Officer at University Hospitals and Clinical Professor of Anesthesiology and Critical Care Medicine at Case Western Reserve University in Cleveland, developed the concept of defects in value. He and co-first author John W. Urwin, MD, of Beth Israel Deaconess Medical Center, Harvard Medical School, and the Department of Medical Ethics and Health Policy, University of Pennsylvania, wrote their model offers a hopeful path forward for improving value in health care.
Using the success achieved at University Hospitals (UH) in Cleveland where annual costs per patient in the UH Accountable Care Organization (ACO) were reduced by 9 percent over the course of 12 months researchers demonstrated that deploying a framework in which specific defects in value were eliminated could not only save money but improve the overall care value proposition. In the UH ACO, they applied this framework to the 37,000