Dr Don Berwick on addressing overuse in the new normal

Dr Don Berwick, President Emeritus and Senior Fellow, Institute for Healthcare Improvement has highlighted how health care systems and providers have an opportunity to learn and change in response to Covid-19.

In his presentation, ‘Addressing overuse in the new normal’, Dr Berwick outlines how sustainability, reducing waste and improving value are vital to meet the complex health needs posed by both the Covid-19 pandemic and our rapidly changing society.

Dr Berwick says six key issues which are important for the Choosing Wisely campaign have been highlighted by the Covid-19 pandemic.

These issues include:

The speed of learning and change
Covid-19 has accelerated the speed of learning and change. Dr Berwick explains that within a few days of the virus arriving in the United States doctors in Seattle had connected with doctors in China. What they learned reached doctors across the US within a matter of days.

Standardisation and commitment to science
The importance of balancing clinicians having autonomy and taking an evidence-based approach. Throughout the pandemic Dr Berwick says clinicians globally are avidly sharing what they are learning.

Virtual care and reconsidering proximity
Dr Berwick describes some providers going from offering 5 percent virtual care to 95 percent virtual care. In the future the benefits and risks with both models of care need to be carefully weighed up. During Covid-19 a lot of routine care has not happened and now there is an opportunity to look at what wasn’t needed in the first place.

Protecting the workplace
Dr Berwick describes this as an emotional issue as many workers in the US did not have the protective gear they needed when Covid-19 hit. He questions how we ensure the wise use of personal protective equipment.

Preparedness
We need to be smart and allow for flexibility, Dr Berwick says. We need to be able to prepare just in time and have capacity to surge when we need to.

Inequity
Dr Berwick explains how globally the pandemic has highlighted equity issues. He believes that if Choosing Wisely is serious about people receiving the help, they need to achieve full health and vitality, clinicians need to look at underlying causes. For example, if someone has health problems related to poverty then Dr Berwick questions if this should become a Choosing Wisely issue.

Dr Berwick’s presentation is available to be viewed on the Choosing Wisely Canada website.