Reducing Low-Value Care in Vulnerable Populations – Changing Care in Practice
The resources below can help safety-net practices, hospitals and systems implement a quality improvement (QI) project to decrease low-value care. They have been broken into sections by time commitment:
- If you have five minutes, check out our top five insights from each area.
- If you have twenty minutes, read sample scripts, review tools or listen to a short podcast.
- If you have an hour to dedicate, read the source journal articles, watch a webinar or join our learning network to connect with others.
If you have five minutes…
Consider these five things when implementing a Choosing Wisely QI project:
Identify the problem: consider working to reduce frequently unneeded testing or treatments that occur at least 40% of the time in your institution.
Consider “balancing” overuse and safety measures with “do no harm” messaging, and/or pairing a low-value care reduction initiative with efforts to increase high-value care (e.g. promoting evidence-based preventive screening).
Use a multi-intervention model when implementing quality improvement efforts to reduce low-value care.
Incorporate Choosing Wisely into practice workflows.
Engage patient and family advisors in planning and implementing your improvement efforts.
If you have 20 minutes…
- Our Choosing Wisely Top 12 recommendations for reducing low-value care
- The CW Implementation Toolkit developed by Quality Counts includes tools to integrate Choosing Wisely into your workflow.
- Sample scripts can help practice staff and clinicians have Choosing Wisely conversations with patients (See page 4 of Quality Counts’ Choosing Wisely Implementation Toolkit).
- Our poster from an Academy Health meeting on reducing low-value care
- The Commonwealth Fund Low-Back Pain case study
- Choosing Wisely implementation case studies from San Francisco and Maine. (TK)
- The AMA’s Steps Forward toolkit includes recommendations for team-based implementation efforts.
- Choosing Wisely toolkits by the Washington State Medical Association
- Choosing Wisely “Bite-Sized Learning Modules” from the Patient-Centered Primary Care Collaborative
- Place “Commitment Posters” in exam and waiting rooms to show your organization’s commitment to reducing inappropriate use of antibiotics.
- Place posters, flyers and cards in waiting or exam rooms, or give them to patients as handouts.
If you have 60 minutes…
- “Enhancing Patient/Clinician Communication: Leveraging Choosing Wisely® as a Tool for Achieving Health Equity”
- “Treating, Fast and Slow: Americans’ Understanding of and Responses to Low-Value Care”
- “Engaging Patients about Overuse at the Point of Care“
- “Empowering Patients to Ask Questions” (Use this for role-play training)
- Interactive instructional modules can enhance physician and patient communication.
- These simulated encounters from both patient and provider points of view can aid conversations about avoiding unnecessary antibiotics.
- Facilitate small group community conversations
If you need assistance with this toolkit or implementing Choosing Wisely in your practice or system, please contact Kate Carmody at firstname.lastname@example.org.