choosing-wisely

The Alliance supports the Choosing Wisely® campaign to promote conversations between physicians and patients to make smart, effective health care choices that lead to high-quality care in Washington state. Choosing Wisely is a national initiative of the American Board of Internal Medicine (ABIM) Foundation in partnership with Consumer Reports. The initiative seeks to advance a national dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures.

About Choosing Wisely

Choosing Wisely aims to promote conversations between clinicians and patients by helping patients choose care that is:

  • Supported by evidence
  • Not duplicative of other tests or procedures already received
  • Free from harm
  • Truly necessary

In response to this challenge, national organizations representing medical specialists asked their providers to “choose wisely” by identifying tests or procedures commonly used in their field whose necessity should be questioned and discussed. The resulting lists of “Things Providers and Patients Should Question” are intended to spark discussion about the need—or lack thereof—for many frequently ordered tests or treatments. Since the campaign’s launch in 2012, 75 medical societies have identified 490 recommendations for patients and doctors to question.

How the Alliance contributes to Choosing Wisely

The Alliance believes in reducing the overuse of services, treatments and procedures that are wasteful and contribute to the enormous cost of health care. Avoidable care does not contribute to better health and leads to more testing to investigate false positives. Physicians and patients need to work together to choose appropriate health care that is supported by evidence, doesn’t duplicate other tests or procedures, won’t cause harm and is truly necessary.

The Alliance has partnered with the Washington State Medical Association, Washington State Hospital Association and health care leaders across the state to implement systematic ways to improve care. The Alliance was one of 21 organizations (including the Washington State Medical Association) that was awarded a grant from the ABIM Foundation in 2013 to promote the goals of the campaign. In 2015, the Alliance was one of seven organizations to receive a second-round grant to further the campaign.

Washington State Choosing Wisely Task Force

The Alliance and its partners support the Washington State Choosing Wisely Task Force that champions and disseminates the principles and resources of Choosing Wisely. This group of leaders is committed to ensuring safe, high-value care for patients in Washington state by significantly reducing health care overuse and waste. They strive to change behaviors and create measurable improvement through education, building practice models and frameworks, and developing resources for providers and health care systems. The task force is focusing specifically on reducing the use of antibiotics for acute upper respiratory viral infections, imaging for uncomplicated headaches, and overly frequent Pap tests for women.

The task force continues to prove the power of partnerships to make an impact on health care. We welcome new member organizations interested in joining the campaign.

Task Force members

View members

For patients

The Alliance’s Own Your Health articles can help you make informed decisions about your health care and talk to your doctor about your health care options. As each patient situation is unique, use the information to guide conversations with your doctor to determine appropriate care for you.

Print the Five Questions to Ask Your Doctor wallet card to help you talk with your doctor and make the best care decisions possible.

For employers

The Alliance’s Choosing Wisely® Employer Communications Campaign helps employers capitalize on the important role they play in improving the health outcomes of their employees and their families. Contact us to receive ready-to-use materials on a monthly basis to share with your employees, using your own communication channels such as newsletters and social media. We make it easy for you to connect Choosing Wisely to your other initiatives and to encourage your employees to become their own best advocates.

For providers and health systems

Read our 2016 report “Less waste. Less harm. Choosing Wisely in Washington state.” It offers county-by-county results for select Choosing Wisely recommendations and shows that substantial variation exists among counties in terms of the number of unnecessary tests and procedures performed. This provides context for the opportunities to improve.

We encourage you to download the Choosing Wisely Action Manual. This free, step-by-step guide to implementing Choosing Wisely activities in your practice environment provides practical tips and helpful resources that can be adapted to fit with an existing change framework that you may already have in your organization.

Here is an overview of the eight steps:

  1. Create urgency – Start talking about why change is important and use data to get people talking and thinking. Engage leaders to get their buy-in.
  2. Form a guiding coalition – Bring together a team of influential people whose power comes from a variety of sources. Seek providers interested in being involved.
  3. Create a vision for change – Build a clear vision with specific tasks to help everyone understand why you’re asking them to make changes and what you’re asking them to do.
  4. Communicate the vision – Walk the talk and demonstrate the kind of behavior you want from others.
  5. Remove obstacles – Recognize and reward people for making change happen. Identify people who have not yet adopted the change. Use data to highlight the need for the initiative and focus on the long-term goal.
  6. Create short-term wins – Break your initiative into smaller pieces. Celebrate progress and express your appreciation.
  7. Build on the change – Build on what went right and identify what you can improve. Agree to make plans together and commit to adjustments if and when needed.
  8. Anchor the changes in the organization’s culture – Make continuous efforts to ensure that the change is seen in every aspect of your organization. Focus on long-term goals and be sensitive to overlapping demands.

Read our report: Less waste. Less harm. Choosing Wisely in Washington state

Consistent with its emphasis on performance measurement, the Alliance was the first organization in the U.S. to produce statewide results for Choosing Wisely measures.

Looking at select Choosing Wisely recommendations, our 2016 report, “Less waste. Less harm. Choosing Wisely in Washington state” shows that 30% of patients with upper respiratory infections were prescribed potentially unnecessary antibiotics. By supporting this campaign with comparable, statewide data on the rates of potentially unnecessary tests and procedures, the Alliance is helping to engage clinicians and patients so that they can make informed health care choices.

Washington State Choosing Wisely Technical Specifications

The task force developed the first methodologies for measuring the rates of selected tests and procedures, which helps to ensure that all Choosing Wisely physician recommendations are supported by evidence. The technical specifications are available to help your practice build the measures into your electronic health records. Contact Susie Dade to learn more.

Resources

Choosing Wisely: Things Physicians and Patients Should Question
Evidence-based recommendations from medical societies on when a test may help, and when it may not.

Contact

Please email Susie Dade at sdade@wahealthalliance.org to learn more.