Since implementing the Choosing Wisely campaign, Group Health has seen lower prescribing rates and better patient experiences in the exam room. For example, there has been a 33 percent drop in inappropriate Pap tests and imaging for headaches.
The STEPS Forward module offers five steps to follow to help your practice implement a Choosing Wisely campaign:
Engage your providers. Let physicians know this program is about patient safety and patient-centered care; don’t focus the conversation on waste and cost reduction. Also, emphasize the approach as a conversation starter, not a mandate on how to treat patients. Let physicians know that medical decision-making is based on a patient’s best interest and the physician’s professional judgment.
Engage your staff. Consider having clinical-support staff give patients Consumer Reports’ Choosing Wisely campaign brochures related to the reason they are seeing the physician, such as a sinus infection, lower-back pain or cancer screening. Reading a handout on sinusitis while waiting to be seen may make the patient more agreeable to a non-antibiotic treatment.
Engage your patients. Choosing Wisely’s success relies on engaging patients in talking about the purpose of tests, treatments and procedures. The goal is for patients to clearly understand what is necessary, what’s not necessary and what could cause them harm. Show empathy for the patient’s desires, needs and concerns.
Establish an implementation plan. Choosing Wisely can be tailored to best fit your organization’s needs. Some practices may want to increase awareness and make handouts available to patients; others may offer a formal education program for clinicians and staff and have checklists and protocols to standardize the process. Some practices may work with the information technology department to embed Choosing Wisely recommendations into clinical decision-support tools in the electronic health records (EHR) system.
Choosing Wisely has created physician communication modules to help educate doctors about the initiative. The modules are targeted toward physicians specializing in family medicine, pediatrics, cardiology, radiology and more.
Use data to understand and improve performance. Track and report data gleaned from sources such as your EHR, pre-printed order sheets and standing orders from team members. Target the tests you believe may be overused, inconsistently used or harmful to patients.
The STEPS Forward module offers even more detailed information to help practices learn about Choosing Wisely. In addition to walking you through the five steps, it answers frequently asked questions about the campaign and offers tools and resources to implement Choosing Wisely.
This module may be completed for continuing medical education credit. There are seven new modules now available from the AMA’s STEPS Forward collection, bringing the total number of practice improvement strategies to 43; several thanks to a grant from, and collaboration with, the Transforming Clinical Practices Initiative.