An initiative of the ABIM Foundation, Choosing Wisely is working to spark conversations between providers and patients to ensure the right care is delivered at the right time. Participating organizations have created lists of “Things Providers and Patients Should Question” which include evidence-based recommendations that should be discussed to help make wise decisions about the most appropriate care based on a patients’ individual situation. Nursing has joined the campaign to improve consumer knowledge with engagement from the following nursing organizations:
The cost of health care in the United States (U.S.) continues to increase with a gross domestic product (GDP) estimated to grow from 17% to 20% by the year 2020 (IHI, 2014). Despite the increases to the GDP, the U.S. trails other nations in numerous health related metrics, which includes “life expectancy at birth and survival with many diseases” (Moses et al., 2013, p. 1947). Ninety-one percent of the increases in cost are attributed to increases in price of care, administrative costs, drugs, medical devices, and professional service fees (Moses et al., 2013). The Institute of Medicine estimates that 30% of the health related costs or due to duplicate or unnecessary tests (Hilborne, 2014). This inappropriate use of testing also contributes to decreased quality of care and possible risks to patients by “leading to more testing and unnecessary procedures or medication” (Hilborne, 2014, p. 40).
The Institute of Healthcare Improvement (IHI) developed a framework, the Triple Aim, around optimization in health system performance that includes “improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care” (IHI, 2014). The IHI Triple Aim advocates that change must occur simultaneously on all three measures by health care providers and organizations to be effective and create optimal outcomes for the patient population (IHI, 2014). This model centers around the individual patient and family, redesign of how primary care is delivered, management of the health of the population, control of costs, and integration at the system level (IHI, 2014).
This campaign is designed to help consumers and physicians engage in conversations about the overuse of tests, procedures and treatments and to help health care consumers make smart and effective care choices. Most recently, the Choosing Wisely campaign partnered with the American Academy of Nursing to further their efforts to help patients and providers work together more effectively. Further work and analysis must be completed as to the effect that the nursing profession has on moving forward the Choosing Wisely® campaign, or a similar effort, by reaching a much larger patient population than the medical profession can do on its own.
What We Do
To date the Choosing Wisely® campaign has:
- Engaged nearly 100 national and state medical specialty societies, regional health collaboratives and consumer organizations
- Identified more than 400 tests and procedures that have been described as overused and inappropriate
- Collaborated with the American Academy of Nursing (AAN). The AAN has since convened national nursing leaders to develop evidence-based recommendations for discussion with patients. The AAN has engaged with the Texas Team Advancing Health Through Nursing to implement a pilot program in Texas.
Have questions regarding this campaign? Email TexasChoosingWisely@gmail.com for more information.