Choosing Wisely Canada (CWC) is a national campaign that started in 2014 to help patients and clinicians discuss the use of unnecessary tests and treatments and to make smart and useful healthcare choices. More than 50 Canadian medical groups (physicians, nurses, pharmacists and other health professionals) have developed over 250 recommendations to consider when making decisions relating to unnecessary tests, treatments and procedures.
The Choosing Wisely campaign is now in over 20 countries that are trying to reduce the overuse of unnecessary services. Past research tells us that providing these recommendations alone will not change practice. Still, the issue of putting these Choosing Wisely recommendations into practice has not received much attention.
We plan to develop a program to put these recommendations into practice by bringing together a national implementation research network including Canadian experts from CWC, implementation science, relevant clinical content areas and knowledge users (including patients, professional associations and provincial healthcare systems) to reduce unnecessary tests and treatments. The network will conduct clinical trials of strategies to put some of these CWC recommendations into practice across 3 Canadian provinces, while making sure to take province specific priorities into consideration. To increase the likelihood that the findings will be put into action, the research will be conducted in partnership with provincial healthcare systems. The trials will focus on two important areas: pre-operative testing in ambulatory surgery and imaging in low back pain.
By reducing the use of unnecessary tests, treatments and procedures in these two areas, both patients and the health delivery system will benefit. Patients will be saved the time and effort and avoid potential harm and the health delivery system will have reduced wait times and increased efficiency.
Dr. Shawn Dowling, University of Calgary