Better Health Greater Cleveland (Better Health) embraced the goals of the Choosing Wisely® initiative to reduce unnecessary and potentially risky uses of health care resources. Primary care has been the principal focus of Better Health’s work to date. Primary care physicians typically have well-established relationships with patients and are the usual source of referrals to specialists and specialized testing. Their knowledge of a patient’s medical history and risk factors, combined with the trust their patient has in them, make them ideally suited to engage patients in conversations about the Choosing Wisely recommendations.
Better Health established an Advisory Committee to initiate the Choosing Wisely activities in Northeast Ohio to select specific recommendations on which to focus.
Better Health used these recommendations to focus on five health care situations that are familiar to thousands of Ohioans, along with the associated tests and treatments that often can be avoided, including:
- cardiac testing
- imaging for acute low back pain
- antibiotics or imaging for sinusitis
- imaging for headaches
- screening for cervical cancer
Better Health developed an educational module for residents and medical students to help them engage their patients in conversations related to imaging for low back pain. The module includes:
- an orientation to Choosing Wisely
- background on the individual guidelines
- an assessment of content knowledge
- scenarios illustrating “bloopers” in provider-patient encounters for facilitated group discussion
- a case using a standardized patient with an evaluation tied to the ACGME milestones
- a self-reflection activity
This toolkit has been delivered in workshop format to residents in internal medicine, family medicine, internal medicine/pediatrics and emergency medicine. Four additional modules are scheduled for completion in mid-2014.
Better Health’s minisite features videos of local physicians who have expert knowledge on the five topics they support. In late 2013, a PSA was distributed to radio stations in Northeast Ohio, reaching over 650,000 listeners.
Better Health Greater Cleveland was established in 2007 with its selection by the Robert Wood Johnson Foundation to participate in its national Aligning Forces for Quality program. Better Health has grown into a 501(c)(3) organization whose members include health care systems, health plans, employer groups and community organizations. Its vision is to help Northeast Ohio become a healthier place to live and a better place to do business.
- “Better Health Greater Cleveland Helps Teach Medical Students and Residents ‘Less Is More’” from Updates From The Field, April 2014