Harkness Project: Improving Resource Use in the Intensive Care Unit
Placement: Kaiser Permanente
Mentors: Murray Ross, Ph.D., director of the Institute for Health Policy; and Elizabeth McGlynn, Ph.D., director of the Center for Effectiveness and Safety Research, Kaiser Permanente
Biography at time of Harkness Fellowship: Matthew Anstey, M.B.B.S., M.P.H., a 2012-13 Australian Harkness Fellow in Health Care Policy and Practice, has been a specialist physician in critical care medicine at Beth Israel Deaconess Medical Center and instructor in anesthesia at the Harvard Medical School since 2010. Prior to coming to the United States, Anstey worked across Australia in regional, urban, and tertiary hospitals as an emergency medicine and intensive care specialist. In 2007, Anstey won the Buchanan Prize for the best Australasian candidate in the specialist exams from the Australasian College of Emergency Medicine. Anstey holds a degree in medicine from the University of Western Australia and a master’s degree in public health from Harvard School of Public Health.
Current Project Abstract: This study aims to investigate the context in which inappropriate intensive care unit (ICU) care (defined as overuse, underuse, or misdirected care) occurs. Potential factors include system issues (e.g., health insurance), hospital-level decisions (e.g., reimbursement, available technology, etc.), and physician decision-making (e.g., patient and family pressure, threat of malpractice, peer norms, and financial incentives). Anstey will first undertake a survey of physicians and nurses at a random sample of California intensive care units on the level of perceived inappropriate care, the ways in which inappropriate care is manifested, and the perceived drivers of this care. Anstey will then conduct semi-structured interviews with key individuals at ten of the surveyed hospitals. These will seek more explanatory information about how the hospital and system characteristics influence resource utilization.
Career Activity Since Fellowship:
- Intensivist, Sir Charles Gairdner Hospital, 2014
- Senior Medical Advisor, Australian Commission on Safety and Quality in Healthcare, 2014
- Stanford Research Collaborator, Clinical Excellence Research Center, Stanford University School of Medicine, 2013
- Intensivist, Sir Charles Gairdner Hospital
- Senior Medical Advisor, Australian Commission on Safety and Quality in Healthcare
Email: [email protected]
Anstey M, Adams J, McGlynn E, "Perceptions of the appropriateness of care in California adult intensive care units," Critical Care. 2015.
Anstey M, Elshaug A, Russell L, Wells S. “Can We Learn Anything from Health Care in the United States?” Medical Journal of Australia. 2014.