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Making it easier to 'choose wisely'
Jeremy N Friedman1,2, Sanjay Mahant1,2
1Division of Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario.
Insights
This commentary introduces a Choosing Wisely top 5 list for pediatric care, addressing the need for child-focused recommendations on appropriate tests and treatments in healthcare.
Area of Science:
- Pediatric Healthcare
- Clinical Practice Guidelines
- Health Systems Research
Background:
- The Choosing Wisely campaign promotes discussions on appropriate medical tests and treatments.
- Existing recommendations primarily focus on adult populations, leaving a gap in pediatric guidance.
- Tertiary care children's hospitals face unique challenges in optimizing care for young patients.
Purpose of the Study:
- To describe the development and initial implementation of a "top 5" list of evidence-based recommendations for the Choosing Wisely campaign, specifically tailored for pediatric patients.
- To encourage broader engagement among healthcare professionals regarding the appropriateness of diagnostic and therapeutic interventions in pediatric care.
- To foster a culture of responsible resource utilization within well-resourced healthcare systems.
Main Methods:
- A commentary format was used to discuss the conceptualization and rollout of the pediatric Choosing Wisely list.
- The process involved identifying key areas for improvement in test and treatment appropriateness in a tertiary care setting.
- The development aimed to create actionable recommendations for clinicians caring for infants and children.
Main Results:
- A "top 5" list of recommendations for Choosing Wisely in pediatric care has been developed and is undergoing early implementation.
- The initiative highlights the importance of adapting adult-focused guidelines to the specific needs of children.
- The commentary serves as a call to action for further discussion and refinement of pediatric care practices.
Conclusions:
- Developing pediatric-specific Choosing Wisely recommendations is crucial for optimizing healthcare for children.
- Healthcare providers must exercise responsibility in utilizing resources to ensure appropriate testing and treatment.
- This initiative aims to promote thoughtful decision-making in pediatric medicine, aligning with the principles of the Choosing Wisely campaign.
Abstract:
The Choosing Wisely campaign has stimulated many clinicians to think about the appropriateness of various tests and treatments. Most of the recommendations published thus far are adult-focused. In this commentary, we discuss the development and early implementation of a Choosing Wisely 'top 5' list specifically aimed at children being cared for at our tertiary care children's hospital. We hope that this will encourage others involved in the health care of infants and children to engage in further thought and discussion about the appropriateness of current tests and therapies. Despite often focusing on the deficiencies, we are privileged to have a highly developed and well-resourced health care system in Canada which allows us tremendous freedom to order tests and treatments. It is incumbent on us as health care providers to exercise that privilege with the utmost responsibility and strive to choose wisely and thoughtfully when selecting tests and therapies for our patients.