Founded in 2003, the Wisconsin Collaborative for Healthcare Quality (WCHQ) is a voluntary, nonprofit consortium of 38 organizations—including health systems, medical groups and hospitals—committed to using the public reporting of comparative measures of performance to catalyze improvements in the quality and affordability of health care in the state, in turn enhancing the health status of individuals and communities.
The Wisconsin Collaborative for Healthcare Quality (WCHQ) recognized the Choosing Wisely campaign as a unique opportunity to educate and engage physicians and patients in meaningful conversations and actions around appropriate care at the appropriate time.
Guided by a multi-stakeholder advisory committee, WCHQ selected 10 of the Choosing Wisely specialty society recommendations to focus on in Wisconsin, and also designed and hosted a Choosing Wisely kickoff meeting attended by 150 people during its initial outreach efforts. Selected recommendations focused on:
- Reducing antibiotic prescriptions for acute bronchitis;
- Reducing diagnostic imaging for low-back pain; and
- Reducing blood transfusions for inpatients.
Froedtert & the Medical College of Wisconsin had worked to reduce the use of unnecessary tests and procedures since before the start of the Choosing Wisely grant. A team heading the work to reduce the use of diagnostic imaging for low-back pain began academic detailing six months prior to the start of the grant. They worked to optimize their decision support and workflows in the EHR system, as well as provide performance data to clinicians and leadership. Another team worked on the reduction of antibiotics prescriptions with academic detailing, workflow enhancements and transparency of data.
Monroe Clinic shared evidence and education with clinical providers, providing monthly, unblinded individual provider and group reports of inappropriate antibiotic use within the organization and incorporating patient education and engagement using Choosing Wisely tools. Monroe Clinic initiated focus on consumers via direct mailing, a radio campaign featuring one of their primary care providers, and a Web page.
WCHQ also worked with its membership to advance the Choosing Wisely campaign through one-on-one meetings, presentations at Grand Rounds and working with patient advisory councils. It shared Choosing Wisely materials broadly across Wisconsin to reach physicians and patients via email, web resources and social media outlets.
Working with its members and health care industry vendors, WCHQ developed decision support tools within EHR systems to improve access to the Choosing Wisely recommendations and other technology-based tools that assisted physicians in recognizing and acting upon appropriate Choosing Wisely recommendations.
Stories of Success
Gradual Change and Learning in Wisconsin
“Our work is unique in the fact that each of our groups are at different stages of the process,” said Charlene Remy, Clinical Quality Coordinator, Froedtert & the Medical College of Wisconsin (F&MCW) at the start of the grant. “Because our three groups are at different stages of development and implementation, we can easily learn from each other and adapt our learnings toward the best path going forward. This has proved to be incredibly helpful so far.”