Choosing Wisely Case Study Competition Winners Announced

The Society of Hospital Medicine (SHM) recently announced winners of its Choosing Wisely Case Study Competition, an effort to highlight innovative implementation of the campaign in hospital medicine.

The competition was part of SHM’s work through a grant from the ABIM Foundation and supported by the Robert Wood Johnson Foundation to advance Choosing Wisely in communities across the country. SHM asked hospitalists to demonstrate how they implemented recommendations from the either the society’s adult or pediatric Choosing Wisely lists in their practice.

The submissions were judged by a panel of SHM members comprising the Choosing Wisely Subcommittee. Winners were declared in adult and pediatric categories:

Grand prize winner in the adult category:

Hyung (Harry) Cho, MD, Director of Quality and Patient Safety at Icahn School of Medicine at Mount Sinai, worked to reduce catheter-associated urinary tract infection (CAUTI) rate by raising awareness about urinary catheters and increasing early removal. The secondary goal was to reduce total catheter days. Read more about Dr. Cho’s work.

Honorable mention winners in the adult category:

• Kevin Flemmons, MD, from Vanderbilt University, created a house staff-led Choosing Wisely Steering Committee with key hospital administration and faculty support to successfully reduce daily lab draws.
• Manya Gupta, MD, from Rush University Medical Center, worked to increase adherence to a restrictive transfusion strategy, decreasing the total number of blood units transfused, as well as the total number of units transfused for hemoglobin greater than 8 g/dL.
• Emily Mallin, MD, of Banner Good Samaritan Medical Center, focused on reducing unnecessary and clinically inappropriate transfusions of packed red blood cells in order to improve patient safety and clinical outcomes while reducing cost.

Grand prize winner in the pediatric category:

Amanda Schondelmeyer, MD’s project at Cincinnati Children’s Hospital Medical Center, attempted to reduce continuous pulse oximetry use to align with Choosing Wisely recommendations as well as improve compliance with the local guidelines, which recommend intermittent pulse oximetry for patients with asthma and bronchiolitis outside of the intensive care unit setting who are on room air.

Honorable mention winners in the pediatric category:

• Matthew Garber, MD, of University of South Carolina School of Medicine, did work related to The Quality Collaborative for Improving Hospitalist Compliance with the AAP Bronchiolitis Guideline (B-QIP), which helps hospitalist-led teams assess and improve care delivered to pediatric patients admitted with bronchiolitis. The project showed that Choosing Wisely recommendations can be implemented across a range of hospitals, including community hospitals without a robust quality infrastructure.
• Sangeeta Schroeder, MD, of Ann and Robert H. Lurie Children’s Hospital, was recognized for two projects. One aimed to reduce the use of routine bronchodilators in children with bronchiolitis. The hospital also conducted a multimodal assessment of its current practice for bronchiolitis, specifically, looking at costs, resource utilization of medications and diagnostic procedures, processes of care and culture of care. The evaluation helped create and implement a Clinical Care Guideline, which aimed to reduce the use of routine chest radiographs in children with bronchiolitis.

Projects that started after Jan. 1, 2013 were eligible for the case study competition and the submissions were judged on:

• Demonstrated  improvement in appropriate utilization
• Demonstrated ability to succeed in sustaining efforts
• Innovation in achieving improvement
• Reduction in wasteful spending
• Institutional commitment to achieving improvement

For more information on the competition and winners visit SHM’s media center.