Wisconsin Collaborative for Quality Healthcare

Advancing Choosing Wisely®, an ABIM Foundation Initiative

A grant from the ABIM Foundation, supported by the Robert Wood Johnson Foundation, brings together WCHQ and two health systems - Froedtert & the Medical College of Wisconsin (MCW) and Monroe Clinic, and two medical societies, the Wisconsin Academy of Family Physicians and the Wisconsin Medical Society - to advance the Choosing Wisely initiative, which encourages clinicians and patients to engage in conversations aimed at reducing unnecessary care.

Froedtert & MCW and Monroe Clinic set goals to achieve a 20% utilization reduction for three high-priority areas over a three-year period, from August 2015 to February 2018. Both health systems are making workflow changes and have noted reductions of antibiotic prescriptions for adults with acute bronchitis, and further process changes are occurring to reduce imaging for nonspecific low back pain. For the third high-priority area, Froedtert & MCW health network has already reduced inpatient blood utilization, and Monroe Clinic has reduced imaging for uncomplicated headache.

As noted above, these efforts focus on internal processes and workflows, as well as move beyond the walls of the clinical setting. Community partners promote culture change, quality of care, and reduce unnecessary care by raising awareness and fostering Choosing Wisely conversations. These goals are being achieved through partnerships of health care providers, health systems, hospitals, medical groups and community organizations.

In addition, this work encourages conversations between clinicians and patients about what care is needed. The above focus areas have clinical, evidence-based background information for clinicians created by the related specialty societies. Patient-friendly, easy-to-understand information sheets (also available in Spanish), developed by Consumer Reports in partnership with the societies, help explain why consumers/patients should question the use of a certain tests, procedures or treatments. The wallet card below offers 5 questions to ask doctors before agreeing to any medical test or procedure, with the goal to reduce unnecessary testing.

Per the Centers for Disease Control and Prevention (CDC), antibiotic use is the leading cause of antibiotic resistance. Up to one-third to one-half of antibiotic use in humans is either unnecessary or inappropriate. Each year in the United States, 47 million unnecessary antibiotic prescriptions are written in doctor’s offices, emergency rooms, and hospital-based clinics, which makes improving antibiotic prescribing and use a national priority. To combat antibiotic resistance and avoid adverse drug reactions, antibiotics should be used appropriately. Below are 5 questions Consumer Reports suggests people ask their providers when discussing the potential use of antibiotics.

This work is important to improve value to the customer and reductions of this kind reduce costs. In the future, WCHQ will sponsor an Assembly meeting featuring the results of this work.