Choosing Wisely helps reduce unnecessary testing for Wide Bay patients
An initiative that aims to reduce unnecessary testing and treatment through evidence-based medicine is achieving great results for Wide Bay patients.
Wide Bay Hospital and Health Service is a Champion Health Service member of Choosing Wisely Australia – part of a global initiative that aims to challenge the notion that “more is always better” when it comes to tests, treatments and procedures.
As part of the initiative, WBHHS has been successfully rolling out a number of projects targeting specific tests or the prescribing of specific medicines. The program has led to some significant changes in areas including pathology, medical imaging and pharmacy*, such as:
- a 14% reduction in CT head scans and an 8% reduction of leg vein ultrasounds at Bundaberg Hospital
- a 1.3% reduction in CT head scans and a 3.2% reduction in CT pulmonary angiogram scans at Hervey Bay Hospital, despite a significant increase in emergency department presentations
- an overall reduction in a range of blood tests at Maryborough, Hervey Bay and Bundaberg hospitals
- A reduction in opioid pain relief prescribing following surgery, allowing patients to be discharged safely home to start their recovery earlier.
WBHHS Acting Executive Director of Medical Services Dr Simi Sachdev said the WBHHS initiatives were based on recommendations from Australia's peak colleges, societies and associations, and targeted because of their relevance to our healthcare setting.
“The number of available tests, treatments and procedures in modern medicine is large and growing, and many are useful only under specific situations,” Dr Sachdev said.
“Not all tests, treatments and procedures are in the patient’s best interest – some are of little to no benefit and, in some cases, can cause harm.
“The right choice should be based on the best available evidence and open discussion between a patient and their health provider.”
Dr Sachdev said the issue of over-testing was a worldwide challenge, and initiatives such as Choosing Wisely were helping to address it.
“The drivers of what we call ‘low-value’ care are complex, and they can include factors such as community expectation, a desire to rule out all possibilities, or the fear of medico-legal action,” she said.
“But it’s important we remember that unnecessary practices are a diversion from high-quality care.
“Choosing Wisely is all about patient safety and not about cost.
“But many tests in modern medicine are expensive, so it’s important we focus on the right tests and treatments for the right patients, to ensure we’re giving our community both the best-quality and the best-value care.
“The success of our Choosing Wisely initiatives so far is a win for our patients and a reflection of the commitment of our clinicians to deliver great care – and we’re eager to continue building on these successes by extending the program further.”
Dr Sachdev said at the end of the day, the quality of the discussion between patients and doctors was critical.
“Combining the doctor’s skill in evidence-based medicine with the patient’s goals and preferences is an effective way to ensure the best care,” she said.
“Patients should also be empowered and encouraged to question whether or not certain tests, treatments or procedures are right for them and whether the test will make a difference to the management of their condition.”
Choosing Wisely has developed five questions for consumers to ask their doctors. They are:
- Do I really need this test, treatment or procedure?
- What are the risks?
- Are there simpler, safer options?
- What happens if I don’t do anything?
- What are the costs?
For information about Choosing Wisely Australia, go to www.choosingwisely.org.au.
* Figures compare January-October 2019 with January-October 2018.