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An echo to Choosing Wisely® in Switzerland
Lionel Chok1, Johann Debrunner1, Sandra Jaeggli1
1Department of Internal Medicine, Medical Clinic, Hospital Uster, Uster, Switzerland.
International Journal of General Medicine
|May 17, 2018
Summary
Implementing "Smarter Medicine" recommendations significantly reduced unnecessary blood draws in hospitalized patients. This initiative lowered blood test frequency, showing promise in optimizing medical practices and potentially improving patient care.
Area of Science:
- Internal Medicine
- Healthcare Management
- Patient Safety
Background:
- Swiss Society of General Internal Medicine developed
- Smarter Medicine
- recommendations in 2016, inspired by US Choosing Wisely®.
- These guidelines identified unnecessary tests and treatments contributing to healthcare costs.
- Recommendations were implemented in Uster Hospital's Internal Medicine Department in August 2016.
Purpose of the Study:
- To evaluate the impact of
- Smarter Medicine
- recommendations on blood draw frequency.
- To assess changes in physician ordering behavior regarding blood tests.
Main Methods:
- Retrospective analysis of hospitalizations at Uster Hospital.
- Comparison of blood draw data from 3 months before and after recommendation implementation.
- Analysis included 2023 hospitalizations.
Main Results:
- A significant decrease in the median number of blood draws per patient was observed post-implementation (4 [IQR, 2-6]) compared to pre-implementation (4 [IQR, 2-7]; P = 0.002).
- The proportion of patients with more than four blood tests decreased from 46% to 39%.
- Interventions included lectures and weekly email communications.
Conclusions:
- The
- Smarter Medicine
- initiative successfully altered physician behavior, reducing unnecessary blood orders.
- Low-cost interventions proved effective in changing practice.
- Further research is needed to determine the impact on patient and clinical outcomes.
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