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Choosing Wisely: An idea worth sustaining.

Monika Kastner1,2, Julie Makarski1, Kathryn Mossman1

  • 1Knowledge Translation and Implementation, Centre for Research and Innovation, North York General Hospital, Toronto, Ontario, Canada.

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|December 3, 2021
PubMed
Summary
This summary is machine-generated.

Choosing Wisely (CW) initiatives in Ontario hospitals show potential for reducing unnecessary medical care. Implementation teams improved sustainability scores, demonstrating the value of empowering healthcare teams.

Keywords:
implementationmixed-methodssustainability

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Area of Science:

  • Health Services Research
  • Quality Improvement Science
  • Implementation Science

Background:

  • Unnecessary medical care represents a significant challenge in healthcare systems.
  • Choosing Wisely (CW) initiatives aim to reduce low-value care.
  • Evaluating the long-term sustainability of CW is crucial for sustained impact.

Purpose of the Study:

  • To assess the sustainability potential of Choosing Wisely (CW) implementation in Ontario community hospitals.
  • To identify facilitators and barriers to CW sustainability.
  • To understand how implementation teams influence CW initiative outcomes.

Main Methods:

  • A mixed-methods approach was employed, combining surveys and focus groups.
  • Validated sustainability surveys were administered to CW implementation teams.
  • Qualitative data from focus groups were triangulated with quantitative survey data.

Main Results:

  • Fifteen CW implementation teams across four hospitals and six primary care teams participated.
  • Improvements in sustainability scores were observed for PPI de-prescribing and BUN/Urea lab testing.
  • Key facilitators included leadership support and team communication; challenges involved awareness and workflow fit.

Conclusions:

  • Choosing Wisely implementation teams can positively influence sustainability outcomes.
  • Empowering implementation teams is vital for maximizing the impact of healthcare innovations.
  • Addressing identified challenges is essential for long-term success of CW initiatives.