What influences clinicians to choose wisely?

Area of Science:

• Healthcare management
• Medical practice improvement
• Health behavior change

Background:

• The Choosing Wisely campaign aims to reduce unnecessary medical tests.
• Pre-operative testing is a common area for potential overuse.

Purpose of the Study:

• To assess the effectiveness of the Choosing Wisely campaign in reducing routine pre-operative testing in a New Zealand hospital.
• To identify barriers and facilitators for changing clinician behavior regarding pre-operative testing.

Main Methods:

• Semi-structured interviews were conducted with 15 general surgeons.
• Interviews explored awareness, effectiveness, barriers, and interventions related to the campaign.
• Thematic analysis was used to analyze interview data.

Main Results:

• Four main themes and 17 sub-themes were identified.
• Key themes included awareness of Choosing Wisely, views on pre-operative testing, barriers to behavior change, and strategies for reduction.
• Clinician awareness of the campaign was noted, but its impact on testing practices was limited.

Conclusions:

• Relying solely on guideline revision and awareness campaigns is insufficient to reduce unnecessary pre-operative testing.
• Implementing additional strategies is crucial to support and drive meaningful behavior change in clinicians.
• Further interventions are needed to effectively decrease routine pre-operative testing.