Continuing the summaries from our Choosing Wisely Implementation Symposium, let’s read about Catherine Epps and the Choosing Wisely initiatives happening at Capital and Coast District Health Board…….
Catherine is the Executive Director for Allied Health, Scientific and Technical at CCDHB. She recalls becoming personally interested in the work of Choosing Wisely because for her the challenge of considering rationalising and refining investigations undertaken, was a new challenge she had not previously considered before. Catherine notes that overseas Choosing Wisely has a predominantly medical focus, however, at CCDHB other workforces have been quick on the uptake for opportunities for implementing choosing wisely in their practice too.
In June 2014 at CCDHB a small group of interested SMO’s led by the CMO met to look at opportunities for clinical innovation, improvement and change. Recommendations were received from working groups about change/ new ideas for improvement. One of their initial projects involved improving the inclusion of clinical details on blood sample request forms. Prior to the project, 43% of blood request forms contained no clinical details. There was impetus to improve these numbers and increase the quality and accuracy of laboratory forms & hence care to patients. During the project, phlebotomists stopped taking blood samples for patients whose forms did not contain clinical details. A dramatic improvement subsequently occurred; at follow up 1 year later only 1% of blood sample request forms lacked clinical details.
Other successful Choosing Wisely initiatives at CCDHB have included; eliminating routine preoperative anaesthetic blood, eliminating non-targeted urinalysis and chest X-rays, and pharmacist reviews and rationalising of polypharmacy, and cross-disciplinary efforts (nursing and dieticians) to reduce TPN rates.
Catherine acknowledges the many staff at CCDHB who have contributed to the work of Choosing Wisely in their workplace. They are learning how best to question their own practice, to challenge each other, and enable both health practitioners and patients to “Choose Wisely”.
You can find all the presentations from our symposium here
Choosing Wisely promotes the four questions all patients should ask their health professional to help them Choose Wisely:
Canadian expert Dr Mike Evans explains why not all testing brings benefits – and the questions every patient should ask. Annual physical checks do not necessarily apply in New Zealand – do discuss what screening tests are right for you with your health professional.
Choosing Wisely New Zealand is health professional led, patient focussed, and here to promote quality care, through better decisions. It is multi professional – engaging doctors, nurses, pharmacists, midwives and other health professional groups – as part of an international community of Choosing Wisely initiatives taking place around the world
Choosing Wisely is a global initiative that has been implemented in a number of countries, including USA, Canada, the UK, Australia and some of Europe.
The campaign aims to promote a culture where low value and inappropriate clinical interventions are avoided, and patients and health professionals have well-informed conversations around their treatment options, leading to better decisions and outcomes.