Reducing Unnecessary Variation in Care – Choosing Wisely Canada

In 2019 Island Health made a commitment to join the Becoming a Choosing Wisely Hospital campaign, an initiative developed by Health Quality Ontario and the Ontario Hospital Association, in partnership with North York General Hospital. This campaign includes a Diving into Overuse in Hospitals resource that provides practical advice and guidance for reducing unnecessary tests and treatments in the hospital setting. The campaign consists of 3 levels of engagement:

  1. Implement the 5 “Quick wins”
  2. Implement an additional 3 Choosing Wisely Canada recommendations through quality improvement methods
  3. Take organization-wide leadership on overuse and promote culture change

With the help of local champions, the Choosing Wisely Canada (CWC) Oversight Committee has tackled all five Level 1 “Quick Wins” and has been awarded Level 1 Designation at CWC. The committee is currently strategizing to seek Level 3 designation of Choosing Wisely Diving into Overuse in Hospitals Campaign.

There is both interest and opportunity for Island Health Medical Staff to engage in Choosing Wisely work at Island Health sites as we begin work on achieving Level 2 and 3 designation.

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Choosing Wisely at Island Health Newsletter, Summer 2021

Choosing Wisely at Island Health Newsletter, Spring 2021

Choosing Wisely at Island Health Newsletter, Winter 2021

Are you ready to Choose Wisely with Island Health? Our second virtual symposium is happening on November 26, 2021!

Registration is now open for our second virtual symposium Choosing Wisely at Island Health!
Click here to register. *Google Chrome is recommended*

Click here for more information on the Choosing Wisely at Island Health November 26 symposium.

New this year, Choosing Wisely is partnering with Physician Quality Improvement to offer a 2-hour Level 1 Introduction to Quality Improvement following the symposium. Attendees can register for this exciting opportunity at the same time they register for the symposium

More details on how to register and what to expect are available by visiting our Choosing Wisely symposium page.

Please join our Community of Practice for the latest updates on current work and opportunities for participation and engagement.

Choosing Wisely Community of Practice

Join the conversation as we work for change!

We invite you to join the Choosing Wisely at Island Health Community of Practice on Yammer.

Discuss areas of interest for improvement and learn how you can get involved. Learn more about opportunities for engagement within Island Health and connect with like-minded individuals to discuss Choosing Wisely recommendations. Get the latest updates as we work towards achieving Level 2 and 3 Choosing Wisely Canada Designation. Build connections and share everyday Choosing Wisely involvement.

 

Yammer is available as an app on your smartphone and can be accessed using your internet browser. Your Island Health login is required to join

Achieving Level 1 Designation Infographic

Island Health was awarded Choosing Wisely Canada Level 1 Designation in December 2020.

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Level 1 Designation: Maintaining Improvement and Supporting Practice Change

 

Thanks to the support and commitment of our medical staff and multidisciplinary team members Island Health successfully implemented the 5 “Quick wins” on the path to achieving Level 1 Choosing Wisely Canada Designation including the uncoupling of PT/INR and aPTT tests and revising ED order panels.

Dr. Brian Berry and Dr. Annemarie de Koker have developed materials in the form of a pamphlet and posters aimed at maintaining this improvement and supporting practice change.

Dr. Brian Berry and Dr. Annemarie de Koker are available to speak to any groups that would like a presentation or discussion on Choosing Wisely unbundling aPTT-PT/INR in EDs. Please feel free to reach out to them directly.

For the most up to date news on Choosing Wisely at Island Health, please join our Choosing Wisely at Island Health Community of Practice on Yammer.

Choosing Wisely at Island Health: Putting recommendations into practice on November 20, 2020

Island Health hosted a 5-hour virtual symposium on Friday, November 20, 2020. This event included presentations on Choosing Wisely Canada initiatives at Island Health, a keynote from David Braley Chair and Professor in Family Medicine at McMaster University Dr. Dee Mangin, and ten engaging breakout sessions to discuss future initiatives and improvement opportunities.

We had 100 registrants ranging from medical staff to multidisciplinary team members and the event was a great success! A special thank you to those involved in planning and for those who participated. 

A detailed program and summary of the event can be viewed here

Answers to questions asked during the panel can be viewed here.  

Planning for future engagement is currently underway and those interested in participating in quality improvement as we seek to achieve Level 2 and 3 designation.

Please join our Community of Practice for the latest updates on current work and opportunities for participation and engagement.

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Level 2 Designation

This requires 3 additional Choosing Wisely Canada recommendations through quality improvement methods, including the collection of baseline data, the intervention and collection of results data.   The oversight committee is reviewing potential options including appropriateness of blood transfusion, electronic fetal monitoring, and antipsychotic use.

Feedback from the Choosing Wisely at Island Health: Putting Recommendations into Practice virtual symposium has helped identify change makers and those excited to engage in this important quality improvement work.

Progress will be shared in the quarterly newsletter, Choosing Wisely at Island Health and the latest updates and opportunities can be found on the Choosing Wisely Community of Practice.

Level 3 Designation

Level 3 designation requires organization-wide leadership on overuse and promotion of culture change.  Choosing Wisely should be part of the hospital’s operating/strategic plan, and at least 10 distinct Choosing Widely Canada recommendations, across multiple hospital departments are implemented (including level 1 and 2 recommendations). Mentorship or collaboration with at least 1 other hospital on Choosing Wisely is required. The current approach of organizational standardization meets the requirement of mentorship/collaboration. The initiative is already an organizational priority under reducing unnecessary variation in care.

Choosing Wisely Medical Staff Engagement Survey

Island Health deployed a Medical Staff Engagement Survey between December 11, 2019 through January 24, 2020 to assess Medical Staff interest in Choosing Wisely. All medical staff with Island Health privileges and 78 medical staff without Island Health privileges were invited to participate. Of those, 547 medical staff completed the survey, with representation across departments.

There is both interest and opportunity for Island Health Medical Staff to engage in Choosing Wisely work at Island Health sites as we begin work on achieving Level 2 and 3 designation.

Additional info:

 Clickhere

Reducing Unnecessary Variation in Care – Choosing Wisely Canada Level 1 Designation infographic

Resources to Maintain Improvement and Support Practice Change 

ER Coagulation Testing QI Project to Improve Test Ordering Practice - Pamphlet

ER Coagulation Testing QI Project to Improve Test Ordering Practice - Poster

Clickhere

Choosing Wisely at Island Health: Putting recommendations into practice detailed program and summary

Choosing Wisely at Island Health: Putting recommendations into practice Sli.do Panel Q&A

Clickhere Island Health Choosing Wisely and Medical Staff Engagement Survey Results, January 2020
Clickhere

Physicians Choose Wisely at Island Health

BC Medical Journal: MDs to Be: BC anesthesiologists reduce carbon footprint  by choosing wisely