New Fellowship Aims to Improve Value and Implement Change

By Cynthia (Daisy) Smith, MD, FACP

Physician and patient organizations alike have increasingly emphasized the importance of improving value in health care and reducing unnecessary (and potentially harmful) care. Choosing Wisely, the ACP’s High Value Care initiative and other programs have successfully stimulated interest and conversation, but what actual steps to take to improve value in hospitals is not entirely clear.

How can we move from interest to action to improve the quality and appropriateness of the care we provide to our patients?

The ABIM Foundation and the American College of Physicians (ACP) are funding a pilot project to help trainees complete and study local projects, and disseminate their findings to the broader medical community with hopes to foster real, on-the-ground change. The Choosing Wisely High Value Care in Action Fellowship (CW-HVC) will give a medical trainee the opportunity to pursue his or her passion for improving value and learn the tools to implement real change in his or her own clinical environment.

Applicants will identify local low-value care (e.g. related to overdiagnosis, overtreatment or the use of higher cost options) and propose a local intervention to improve the quality of care. The CW-HVC fellow will be chosen based on the importance of the problem and the quality of the proposed intervention. Once chosen, the fellow will receive training and mentoring to allow her to successfully complete the project and present it on a national stage. First, he will have the opportunity to learn about the science of “knowledge translation” at the three-day New York Academy of Medicine TEACH conference in August, where he will develop and refine his planned project. She will then work on the project with mentoring from both a local mentor and CW-HVC mentors (including a statistician) and have the opportunity to present the work at the national ACP meeting the following spring. Mentors will also help the fellow write a report of the project, with the goal of publication in a peer-reviewed journal.

The CW-HVC fellowship program will help trainees implement real change while learning new skills and receiving mentoring and national exposure. Application information is available at: and are due on 3/11/2015. The selected fellow will be notified during the last week in March.


Cynthia (Daisy) Smith, MD, FACP is Director, Clinical Program Development and Senior Physician Educator at the American College of Physicians.

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