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How one health system persuaded its doctors to change. Hint: It wasn’t easy.

Women who received an "adhesion barrier" after a cesarian section had no better outcomes. (Brett Neilson: Flickr)

Women who received an "adhesion barrier" after a cesarian section had no better outcomes. (Brett Neilson: Flickr)

By: Emily Bazar

The Banner Health system, which stretches from Alaska to Arizona, delivers about 30,000 babies a year, about a third by cesarean section.

When Banner officials scoured their data, they found wildly different patterns in how those C-sections were performed.

That was the easy part. Getting doctors to change their behavior proved more challenging.

“We realized just asking them was not going to cut it,” said Ken Welch, chief medical officer of Banner Estrella Medical Center in Phoenix.

We described Banner’s efforts to rein in variation in a recent USA TODAYBut we didn’t get into the nitty gritty of how the system convinced doctors to change. It’s an object lesson in the difficulty of getting doctors to change, but also the lengths to which health systems and insurers will go these days to make it happen.

Let’s start from the beginning. In its data analysis, Banner found striking differences in the use of pieces of film or fabric — called adhesion barriers — during C-sections. Some hospitals used the barriers during 79 percent of C-sections, while others used them less than 1 percent of the time.

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