October 2020 Learning Network Resources

Tuesday, November 17 @ 4PM EST

Please join us for a webinar with Andrew Whitman, Pharm.D., Clinical Pharmacist in Oncology/Palliative Care at University of Virginia Health System. Register here.

 

Blogs, Issue Briefs, Opinion Pieces and More…

 

  • “You need this drug,” and other things clinicians should stop saying. Lown Institute. September 2020
    “You don’t have to be a professional to do all these things. You just need to know about the drug side effects, which often can be found online as well as the drug insert. And family members are usually best positioned to notice drug side effects, because they may see a change and think, ‘Mom or Dad didn’t seem to be like that before.’ But they may not feel empowered to talk about these changes with the clinician, or they had not been warned about side effects before. Patients and families can help prevent adverse drug events by keeping a lookout for new symptoms — but it will only work if the clinician is willing to listen.”

 

Journals

  • Liu N, et alt. Unnecessary use of radiology studies in the diagnosis of inguinal hernias: a retrospective cohort study. Surgical Endoscopy. September 2020
    ”Nearly 50% of all patients who receive any related imaging prior to surgery had potentially unnecessary diagnostic radiology studies. This not only exposes patients to avoidable risks, but also places a significant economic burden on patients and our already-strained health system.”

  • Markham JL, et alt. Variation in Early Inflammatory Marker Testing for Infection-Related Hospitalizations in Childrenv. Hospital Pediatrics. September 2020
    “Inflammatory marker testing varied widely across hospitals. Hospitals with higher inflammatory testing for one infection tend to test more frequently for other infections and have longer LOS, suggesting opportunities for diagnostic stewardship.”

  • Amadio, et alt. Impact of Appropriate Use Criteria for Transthoracic Echocardiography in Valvular Heart Disease on Clinical Outcomes. Journal of the American Society of Echocardiography. September 2020
    “Patients with appropriate TTE for VHD were more likely to undergo subsequent cardiac testing within 90 days and valve intervention within 1 year than those with a rA TTE. The 2011 appropriate use criteria for TTE have important clinical implications for outcomes in patient with VHD.”

  • Salazar JW, et alt. Two Remedies for Inappropriate Percutaneous Coronary Intervention—Closing the Gap Between Evidence and Practice. JAMA Intern Med. September 2020
    “In this issue of JAMA Internal Medicine, we highlight 2 articles that demonstrate how to close the gap between evidence and practice to reduce low-value care in the context of percutaneous coronary interventions (PCIs) for patients with stable coronary artery disease (CAD),2,3 a procedure with a long history of low-value use and potential harm.”

  • Kerr EA, et alt. Identifying Recommendations for Stopping or Scaling Back Unnecessary Routine Services in Primary Care. JAMA Internal Medicine. September 2020
    “In this study, a total of 178 unique opportunities to deintensify routine primary care services were identified, and 37 of these were validated as high-priority deintensification recommendations. To date, this is the first study to develop a model for identifying, specifying, and validating deintensification recommendations that can be implemented and tracked in clinical practice.”

  • Baker M, et alt. Appropriate CT cervical spine utilisation in the emergency department. BMJ Open Quality. September 2020
    “Over 40 000 CT scans are performed in our emergency department (ED) annually and utilisation is over 80% capacity. Improving medical appropriateness of CT scans may reduce total number of scans, time, cost and radiation exposure. A validated clinical decision-making tool implemented into the medical record can improve quality of care. This study lays a foundation for other imaging studies with validated support tools with similar potential improvements.”

  • Crowe B, et alt. Things We Do for No Reason™: Routine Correction of Elevated INR and Thrombocytopenia Prior to Paracentesis in Patients with Cirrhosis. Society of Hospital Medicine. September 2020
    “Case series representing diverse institutional experiences with thousands of patients consistently demonstrate that bleeding after paracentesis is rare (<1%), mortality from bleeding occurs very infrequently, and neither INR nor platelet counts predict bleeding risk during paracentesis in cirrhosis. These studies demonstrate that abandoning routine correction of coagulopathy does not lead to worse outcomes, can avoid potentially significant transfusion-related adverse events, and can save scarce resources. Returning to our clinical scenario, the hospitalist should not transfuse FFP or platelets and should not delay the diagnostic paracentesis.”

 

Media Coverage

  • Connecticut Choosing Wisely Collaborative Winds Down Operations After Six Years of Promoting Widespread Adoption of Choosing Wisely® Campaign Across Connecticut. CISION. October 2020
    “The Connecticut Choosing Wisely Collaborative (CCWC), a diverse multi-stakeholder group committed to the widespread adoption of Choosing Wisely® in Connecticut, has accomplished its goals and has decided to wind down. The group was formed in 2014 to raise awareness in Connecticut about the Choosing Wisely® campaign and to be a catalyst to accelerate the adoption of Choosing Wisely in the State. The CCWC has worked to promote Choosing Wisely as a vehicle to support efforts across Connecticut to improve health care quality, lower health care costs and advance health equity.”

  • New Choosing Wisely pharmacy recommendations. New Zealand Doctor. September 2020
    “More than 40 New Zealand pharmacists have worked together to develop new Choosing Wisely pharmacy recommendations. Initially the group of New Zealand pharmacists reviewed recommendations from other pharmacy groups world-wide. They then narrowed them down to the ones they believe work in a New Zealand context and would have the most impact.”

  • Mayo Clinic Q&A: Is an Annual Checkup Really Necessary? Chicago Health. September 2020
    “Overall, it is important to stay up to date on all your recommended screenings and vaccines, and a regular checkup will ensure this occurs. But more importantly, the time spent face to face building a relationship with your primary care provider will allow you to create an individualized care plan that meets your needs and optimizes health outcomes.”