WCH Designated a Level 1 Choosing Wisely Canada Hospital
Women’s College Hospital (WCH) was recently recognized as a Level 1 Choosing Wisely Canada hospital. The designation recognizes WCH’s commitment to the reduction of routine nonessential testing and treatments that are not supported by evidence and do not promote high-quality care.
While many assume that more care is better care that is simply not the case. In fact, research shows that roughly 30 per cent of tests, treatments and procedures are potentially unnecessary. Low-value care can increase wait times and can expose patients to potential harm or adverse events. By eliminating excess tests and treatments, WCH is working to ensure that hospital resources are being used where they are needed most, reducing wait and processing times, while improving the quality of patient care.
WCH’s efforts to reduce inessential care has been led by Dr. Geetha Mukerji, a staff endocrinologist, general internist and a WCH Institute for Health Systems Solutions and Virtual Care (WIHV) innovation fellow. Working with other members of the WIHV team, they have showcased the implementation of five initiatives that reduce unnecessary care at WCH based on Choosing Wisely’s recommendations to receive this hospital accreditation status. WCH has adapted the existing Choosing Wisely recommendations to the ambulatory care setting.
For example, a clinical decision support tool within WCH’s electronic medical record serves as a point of care reminder to reduce nonessential repeat Vitamin D testing in low risk adults with previously normal values. Excessive routine preoperative testing such as EKGs prior to low risk surgery and mandatory weekly urine drug screening tests within the WCH Rapid Access Addiction Medicine program have also been reduced. These tests are time-consuming and limit patients’ ability to participate in other life activities and doesn’t improve care.
Next up, the team will be implementing additional Choosing Wisely Canada recommendations using quality improvement processes to receive a Level 2 designation.