Local organizations use Choosing Wisely to improve quality of patient care

Last week we posted about the accomplishments of our Choosing Wisely campaign, a national initiative helping physicians and patients have conversations about the overuse of tests and procedures and supporting physicians’ efforts to help patients make smart and effective care choices. In this second installment of our three-part blog series, we are highlighting the impact of this campaign by showing how four health care systems have used Choosing Wisely to reduce waste and improve patient care. These case studies are from our Spotlight on Improvement series that highlights real stories of health care quality improvement.

Rockwood Clinic

When the Choosing Wisely® campaign launched in 2011, Rockwood Clinic was like most health organizations across the country―wondering how to implement recommendations that are so different from the typical “do more” guidelines, such as health screenings or A1c tests for diabetics. But through commitment from their leadership and careful planning, they successfully embedded the recommendations into their existing quality improvement culture.

Swedish Medical Center

Sometimes a seemingly simple innovation can have a big impact. Swedish Medical Center changed the practice of ordering “daily labs,” the practice of lab automatically ordered for every day a patient is in the hospital. Following Choosing Wisely recommendations, Swedish Medical Center encourages physicians to only order tests that are clinically relevant. The results? This simple process change is resulting in 14,000 fewer unnecessary lab tests annually.

Chart showing results from Swedish’s hospitalist team effort to reduce unnecessary daily lab ordering across four hospitals, comparing before the intervention (September 2012–February 2013) to after the intervention (September 2013–February 2014). — Results from Swedish’s hospitalist team effort to reduce unnecessary daily lab ordering across four hospitals, comparing before the intervention (September 2012–February 2013) to after the intervention (September 2013–February 2014).

Group Health Cooperative

Group Health used the Choosing Wisely campaign as a way to encourage provider and patient conversations on the necessity and safety of tests, treatments and procedures and to avoid unnecessary or potentially harmful care. They paired this with an electronic medical record trigger tool to help reduce unnecessary testing and reduce wasteful spending.

Virginia Mason Medical Center

Inappropriate use and overuse of antibiotics is a serious public health threat and is addressed by several specialty societies’ Choosing Wisely recommendations. Following Choosing Wisely recommendations, Virginia Mason reduced their inappropriate antibiotic use by over 50 percent.

Chart showing Virginia Mason's rate of antibiotic prescriptions, 2011-2014 — Results from Virginia Mason primary care quality improvement efforts to reduce antibiotic prescriptions across eight regional medical centers (January 2011 to July 2014).

Be sure to check out the third blog post in this series when it publishes later this week where we will share our hopes for the future of Choosing Wisely in Washington state.

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