About Choosing Wisely
More is not always better. The same is true for medical tests and treatments. The George & Fay Yee Centre for Healthcare Innovation (CHI) is partnering with Diagnostic Services Manitoba (DSM) to lead Choosing Wisely Manitoba (CWM), a campaign aimed at improving the appropriate use of diagnostic testing in Manitoba.
CWM is based on the national Choosing Wisely Canada (CWC) initiative, which focuses on areas where evidence overwhelmingly shows that a test, treatment or procedure provides no benefit to a patient.
CWM takes a complex adaptive systems approach to help re-design and transform healthcare. We examine the relevant systems to understand current processes, issues and opportunities. We engage physicians, other healthcare professionals and patients in conversations about unnecessary tests, treatments and procedures, and help physicians and patients make smart and effective choices to ensure high-quality care. We engage a variety of stakeholders in focus groups, think tanks and engagement sessions to explore barriers, facilitators, evidence-based practices, cultural and context specific considerations, health systems issues and opportunities in order to create innovative strategies. We include interactive evaluation processes and PDSAs to test these strategies, and we are developing system-wide monitoring and evaluation strategies to assist with ongoing feedback and strategic learning. Sustainability and spread are forefront in our approach to process improvement. A key principle of the initiative is that we report, publish and share our learnings.
Dr. Brock Wright - WRHA-Senior Vice President, Clinical Services and Chief Medical Officer
Mr. Jim Slater - DSM-Chief Executive Officer
Dr. Eric Bohm - Director - Health Systems Performance
Choosing Wisely: Improving Preoperative Diagnostic Testing “Getting it Right”
Ongoing project July 2016:
Eval on project May 1, 2014
08/12/16: 5 docs (forms, letters templates, guideline) launched to primary care and surgery to reduce prompts for unnecessary testing. Awaiting data.
The goal of this Choosing Wisely Campaign is to ensure all Manitobans receive necessary and appropriate pre-operative diagnostic testing for elective surgeries through the sustainable implementation of standardized, evidence informed clinical practice guideline. In support of this over-arching goal, the objectives for the Campaign include:
- Understanding barriers for clinical adoption and implementation of best practice guidelines through stakeholder engagement
- Testing of implementation strategies through the Plan Do Study Act (PDSA) cycles and developmental evaluation approaches
- Creation of a sustainable process for on-going monitoring and to support guideline adherence that can be incorporated into existing operations
26 July 2016 - DSM - Jim Slater spoke to Eric Bohm re support for the system review KS Media Consult. Several rounds of form redesign. Ongoing. DSM - Jim Slater spoke to Eric Bohm re support for the system review PM Intake date July 1, 2014 Large partnership project with surgery, anesthesia and DSM. Has MPAN funding ($200K)
27 Sep/16 - consult assistance from DS closed 27 Sept 16
Choosing Wisely: Appropriate Vitamin D Deficiency Testing
Ongoing Project - July 2016, Aug 19, 2016/Eval - close for Eval as/ Colleen May 18, 2017
PMO closed Sept 22, 2016
Nov 9, 2015 - Rasheda primary contact for DS
KT closed KT joined project May 15, 2015
DS closed 1 jun 17
In Manitoba, testing for Vitamin D levels has grown significantly in the past 8 years from approximately 5,000 tests in 2006 to an estimated 50,000 by 2015/2016, an increase of approximately 900%.
The goal of this project is to identify patterns associated with unnecessary testing, as well as to quantify the number of unnecessary tests being ordered and/or completed. Once the findings of the project have been verified, a baseline for appropriate testing levels will be established. Alongside this project is another titled Appropriate Vitamin D Deficiency Testing, which aims to reduce the amount of unnecessary Vitamin D tests to more appropriate levels as indicated by the Characterization of Vitamin D in Manitoba project, leading to an enhanced patience experience.
Think Tank: Creating a Meaningful Physician Engagement Model to Enable Health Systems Transformation in Manitoba
In collaboration with Diagnostic Services Manitoba (DSM) and the Canadian Agency for Drugs and Technology in Health (CADTH), CHI led an organizing committee that hosted a one-day ‘Think Tank’ workshop: Creating a Meaningful Physician Engagement Model to Enable Health System Improvement in January 2015.
The event brought together participants including physicians, provincial and regional administrators and researchers to understand current physician engagement best practices, to share about the current state of physician engagement in Manitoba and best strategies moving forward. The Think Tank allowed for the beginning of authentic conversations due to the high ratio of physicians to administrators.
To view a report from the day, please click here.
For more information on the CHI-DSM Choosing Wisely Initiative please contact Albert Mota at email@example.com.