Choosing Wisely Champions
The Choosing Wisely Champions program launched in March 2016 to recognize clinicians who are leading efforts to reduce overuse and waste in medicine. The program was created to acknowledge the work of those dedicated to providing appropriate care and encourage others to follow their lead.
Champions are selected by participating societies and include clinicians or teams of clinicians whose work in their respective specialties represents significant contributions to advancing the goals of the campaign. Such contributions can include:
- creation of an intervention to implement Choosing Wisely in their clinical practice;
- designing local initiatives to educate colleagues; or
- playing a leadership role in developing society recommendations.
AMDA – The Society for Post-Acute and Long-Term Care Medicine
David Nace, MD, MPH, CMD (2019) — Dr. Nace and his team developed guidelines and tools for improving the diagnosis and treatment of uncomplicated cystitis in post-acute and long-term care (PALTC) settings.
Peter Jaggard, MD, CMD; Rosina Finley, MD, CMD; Fatima A. Naqvi, MD, CMD and Karl Steinberg, MD, CMD, MHDC (2019) — Dr. Jaggard and his team used the society’s Advance Care Planning Series to develop, promote, and document the content of discussions between patients/families and their physicians to increase attention to person-centered, palliative and end-of-life care.
Dheeraj Mahajan, MD, CMD (2018) — Dr. Mahajan designed an initiative to reduce the incidence of urinary tract infection (UTI) in nursing home patients transferred to emergency departments.
Anuj Bhatnagar, MD, CMD (2017) — Dr. Bhatnagar teaches nursing and front-line staff about the fundamentals of assessing urinary tract infections (UTIs) in older adults.
David Smith, MD, CMD (2017) – Dr. Smith educates prescribers about acute UTIs and the use of antibiotics.
American Academy of Allergy Asthma and Immunology
Kristin Sokol, MD (2016) — Dr. Sokol works to improve care for asthma patients and reduce overtesting for food allergies.
American Association for Pediatric Ophthalmology and Strabismus
Sean Donahue, MD (2016) — Dr. Donahue’s efforts include initiatives to ensure children don’t get glasses they don’t need.
Jean Ramsey, MD (2016) — Dr. Ramsey has led efforts to defeat state legislation mandating pediatric comprehensive eye exams, instead requiring that all children undergo vision screening prior to starting kindergarten.
American College of Emergency Physicians
Carolyn Holland, MD (2018) — Dr. Holland and the QUEST team at the University of Florida created care pathways and embedded clinical decision rules into their electronic health record as guided by each of the ACEP Choosing Wisely recommendations. They have since measured decreased use of low-value care as a result.
Keith Kocher, MD (2018) — Dr. Kocher leads the MEDIC team, which uses data from hundreds of thousands of patients in Michigan to implement and assess initiatives to reduce unnecessary CT scan use in the ED, in line with Choosing Wisely recommendations. (Individual Award).
Henry Zeng, MD (2018) — Dr. Zeng created a system to identify patients appropriate for hospice care and link them to services directly from the ED. Dr. Zeng also created a didactic curriculum on palliative care in his department. (Resident Award)
Mark Baker, MD (2017) — Dr. Baker led a system-wide Choosing Wisely committee at Hawaii Pacific Health System in Honolulu, Hawaii; promoted incorporation of Choosing Wisely recommendations and decision-support tools into their electronic medical record; and gave numerous lectures and interviews on best practices for incorporating Choosing Wisely recommendations into emergency care.
Christina Creel-Bulos, MD (2017) — Dr. Creel-Bulos launched a program at Washington University in St. Louis, Missouri to promote use of palliative care in the emergency department and led teaching sessions for both residents and nurses to support this change in practice.
David Zodda, MD (2017) — Dr. Zodda and his team at Hackensack University Medical and Trauma Center designed and implemented a series of institutional paradigms based on Choosing Wisely recommendations, including one focused on appropriate spine imaging.
American College of Radiology
Jeffrey P. Kanne, MD (2017) – Dr. Kanne helped create multiple ACR Appropriateness Criteria and reduced routine ordering of daily chest radiographs for patients in intensive care, and routine pre-operative chest radiographs for asymptomatic, low-risk patients.
American Geriatrics Society
Rebecca Dobert (2019) – A champion of age-friendly health systems, Ms. Dobert has led change to enhance screening for cognitive and functional impairment and markedly improved documentation of health care proxies and advance care planning in the inpatient and outpatient settings at Baystate Medical Center Division of Geriatrics and Palliative Care.
Alina Sibley, APRN, BC (2018) — At Baystate Medical Center, Ms. Sibley led a Geri-Pal interprofessional outpatient team that facilitated training for nurses and other Baystate staff, which helped reduce the use of restraints, antipsychotics, and benzodiazepines—a critical priority from the American Geriatric Society Choosing Wisely recommendations.
Eric Anthony Lee, MD (2017) — As co-chair of the High Risk Drugs in the Elderly Committee for Kaiser Permanente, Southern California, Dr. Lee is a recognized authority on appropriate prescribing for older men and women.
Ariel Green, MD (2016) — In addition to incorporating Choosing Wisely in her practice, Dr. Green has helped educate her colleagues, patients and families through local, national and international meetings.
Heidi Ann Courtney (2016) — Courtney’s work has resulted in more than a thousand drug adjustments for patients, including an effort aimed at delirium prevention that decreased incidence from 20.8 to 15.1 percent in the first year.
American Medical Society for Sports Medicine
Anuruddh Kumar (A.K.) Misra, MD (2016) — An early adopter of Choosing Wisely, Dr. Misra incorporates regularly uses Consumer Reports’ Choosing Wisely materials to help educate patients on a one-on-one basis in his clinical practice.
American Society for Clinical Pathology
Gary W. Procop, MD, MS, MASCP (2019) — Dr. Procop pioneered test utilization analysis at the Cleveland Clinic health system by introducing effective methods to control unnecessary testing, applying algorithms to electronic measures. With other pathologists and specialists in internal medicine, Dr. Procop initiated evidence-based analysis of utilization patterns and contributed to the identification of circumstances in which tests are ordered in an inappropriate manner.
Inova Laboratory Test Utilization Best Practice Team (2019) — Inova Health System Laboratories has successfully implemented several single test utilization control measures to create simple, rule-based order options related to CBC automated differential testing, BNP order guidelines, and CK-MB reflex order. With these simple changes, many unnecessary tests were reduced. The team also took on an ambitious project to create “Interval Test Allowance Rules” to control duplicate testing and unnecessary repeat testing based on clinically accepted interval rules.
Red Blood Cell Utilization Project Team, UCLA Health (2019) — UCLA Health utilized IT-enabled strategies to increase the number of guideline-indicated red blood cell transfusions and decrease the number of routine two-unit transfusions. Along with educational efforts, the initiative resulted in a sustained and continued improvement in overall red blood cell ordering practices.
Charlene Bierl, MD, PhD (2019) — While director of clinical laboratories at Cooper University Hospital, Dr. Bierl and her team developed high-level metrics to monitor the financial impact of utilization efforts, as well as feedback reports for ordering clinicians. Two of her published studies examine the impact of weekly feedback on test ordering patterns and cost per case mix index-adjusted hospital day as a measure of effective laboratory utilization efforts in a growing academic medical center.
Stephen Sibbitt, MD, MBA, FACP (2019) — Dr. Sibbitt is leading an initiative to achieve “Medicare Break Even” within the flagship hospital of Baylor Scott & White Health. He is guiding a multidisciplinary team to reduce unnecessary expenses related to reduction in length of hospital stay, unnecessary lab and radiology utilization, inappropriate utilization of high cost medications, and cost-inefficient variation in provider practice.
Rana Nabulsi, PhD, FACHE, MSc, CPHQ, SSGB (2019) — Dr. Nabulsi, a consultant in the Head of Quality Assurance Unit in the Pathology and Genetics Department at Dubai Health Authority, has promoted the Choosing Wisely guidelines in her training, meetings, and utilization committee, and has done speaker sessions for the same. She has implemented Choosing Wisely guidelines in her organization and conducted operational activities such as moving from ESR to CRP and limiting Vitamin D testing to only high-risk categories.
Ila Singh, MD, PhD (2018) — Dr. Singh created the Clinical and Laboratory Standards Institute (CLSI) document on test utilization, and her membership on the national committee on Lab Test Utilization and Stewardship that co-authored the consensus document on the subject.
Curtis A. Hanson, MD (2018) — Dr. Hanson led the incorporation of laboratory utilization rules into the inpatient hospital practice and Mayo’s clinical decision support tool.
Diane George, DO (2018) – Dr. George led a group at Henry Ford Medical Group in Detroit, MI to establish a baseline of ordering volume and developed an analytics tool to monitor total volume, as well as highlight low and high utilizers. Within the first year of implementation, the number of Vitamin D orders decreased from 685 per month to 150 per month, and the number continues to decrease at an annual rate of 23 percent.
James Littlejohn, MD, PhD (2018) – Dr. Littlejohn evaluated data pulled from the operating room’s electronic medical record and worked with a team to produce an intuitive user interface for the perioperative transfusion dashboard. The team then strategized the best approach to begin a perioperative blood management campaign, and produced and administered a survey on perioperative red blood cell transfusions.
Heather Signorelli, DO (2018) — Dr. Signorelli for created laboratory stewardship programs for two hospital markets that led to an annual savings of over $2 million.
Jack Jordan, MA (2017) — As Director of Performance Excellence and Quality at Henry Ford Health System, Dr. Jordan worked to make the utilization of laboratory services evidence-based, safer and compliant with Choosing Wisely recommendations.
Meghan Kapp, MD (2017) — Dr. Kapp served as a founding member and co-chair of VUMC’s Choosing Wisely steering committee, educating house staff and faculty about the potential harm of daily labs, encourage discussions of lab results and the need for future labs during rounds and provide data feedback with peer comparisons.
Christopher Polage, MD (2017) — Dr. Polage published peer-reviewed research that contributed to the Infectious Diseases Society of America’s (IDSA) Choosing Wisely recommendation for clinicians to avoid testing for a Clostridium difficile infection in certain situations.
Massachusetts General Hospital, Department of Pathology (2016) — The Division of Laboratory and Molecular Medicine within the Department of Pathology hosts a highly active, division-wide laboratory utilization management program that includes participation from all division faculty.
Cedars-Sinai Health System (2016) — Cedars-Sinai has seen an annualized cost savings of more than $6 million and improved the quality and safety of care from implementing Choosing Wisely recommendations across the health system.
Geisinger Health System (2016) — The Geisinger Medical Laboratories has tackled various test utilization opportunities in anatomic and clinical pathology using a variety of modalities to effect change.
Dana Altenburger, MD, FASCP, FCAP (2016) — Dr. Altenburger has decreased inpatient blood product usage by 46% over three years.
Ilan Rubinfeld, MD, MBA (2016) — Dr. Rubinfeld has spearheaded several laboratory-related initiatives and projects.
American Society of Echocardiography
Patrick Hughes, MD (2016) – Dr. Hughes and his colleagues developed a tool called The Guide to Ordering Stress Tests to help referring physicians recognize when a stress test may not be appropriate for a patient – either because the patient was too low-risk for the test to be helpful or the patient was at such high-risk that a stress test might actually be harmful.
American Society of Hematology
Adam Binder, MD (2018) — Dr. Binder and his colleagues at Montefiore Medical Center developed a process improvement initiative to increase the appropriate use of vancomycin for neutropenic fever over a 10-month period. This initiative led to a 17 percent increase in appropriate prescribing.
Ming Lim, MD (2018) — Dr. Lim helped implement a centralized hospital-wide protocol that coordinated testing and treatment of patients suspected to have heparin-induced thrombocytopenia (HIT), which led to improved testing and management of these patients and substantial reduction in the use of direct thrombin inhibitors.
Prakash Vishnu, MD (2018) — Dr. Vishnu and his team at Mayo Clinic in Jacksonville, FL, designed and set up an electronic medical record-based restrictive RBCt program as part of a quality initiative at Mayo Clinic’s hematopoietic stem cell therapy center. Clinicians, hematology trainees and nurses were educated about this program with weekly didactic sessions, pamphlets, and verbal instruction for two months. The intervention ultimately led to a significant decrease in transfusions and an estimated cost reduction of over $22,000.
Yulia Lin, MD (2017) — After observing a patient who was eventually determined to have iron-deficiency anemia (IDA) repeatedly visit the emergency department and receive repeated transfusions, Dr. Lin and colleagues worked to reduce inappropriate transfusions for patients with the same condition.
Matthew Schefft, DO (2017) – Dr. Schefft and colleagues used individualized pain plans (IPPs) to reduce pediatric emergency department admission rates for children with sickle cell disease presenting with vaso-occlusive crisis (VOC), a frequent event for children with the disease.
Marc S. Zumberg, MD (2017) – Dr. Zumberg and his colleagues worked with the College of Pharmacy and local blood bank to create institutionally approved indications for use of recombinant VIIa (rVLLA), prothrombin complex concentrates (PCCs) and blood products.
Maria Juarez, MD (2016) – To address variability in blood utilization across Baylor Scott & White Health’s hospitals, Dr. Juarez and her colleagues developed an institutional clinical practice recommendation, modified transfusion workflow in the electronic health record (EHR), and launched an educational campaign (“Why Give 2 When 1 Will Do?”), resulting in single-unit transfusions increasing by approximately 17 percent.
Javier Munoz, MD (2016) – Dr. Munoz and his colleagues at Banner MD Anderson Cancer Center implemented an intervention designed to test whether an automatic alert in an EHR could remind clinicians to carefully weigh the anticipated benefits against the risks of post-treatment imaging scans for patients with lymphoma, and resulted in reducing the overall number of imaging studies from 48.3 to 25.3 scans per month.
Ravi Sarode, MD (2016) – After discovering approximately 85 percent of thrombophilia tests at UT Southwestern’s two teaching hospitals were ordered incorrectly or incompletely, Dr. Sarode’s team developed local guidelines and implemented them in the EHR via a series of cascading questions that providers must answer before ordering tests. After implementation of the intervention and an associated education campaign, UT Southwestern has reduced thrombophilia testing for inpatients in the university hospital by more than 90 percent.
American Society of Nuclear Cardiology
Sudip Saha, MD; Joseph Lodato, MD and Nancy Ortiz, MPH, CPHQ, PMP (2019) — For a multi-pronged approach to optimize nuclear cardiology testing and improve safety at Kaiser Permanente, Mid-Atlantic states (Virginia, Maryland and Washington, DC)
Benita Philip, DO; Barbara Schechter, DO; Denise Kale, CNMT and Renee P. Bullock-Palmer, MD, FASNC (2019) — For development of a patient-centered, cost-effective algorithm utilizing 99mTechnetium-Pyrophosphate imaging to diagnose ATTR cardiac amyloidosis
Anirudh Kumar, MD; Paul Cremer, MD; Rory Hachamovitch, MD, FASNC and Wael Jaber, MD (2019) — For a study on the impact of a novel myocardial perfusion imaging risk classification scheme on referral for coronary angiography, revascularization, and mortality
Chris Johnson, MD; Nadine Gauthier, MD; Angeline Law, MD; Eugene Leung, MD and Calvin Thompson, MD (2018) – The winners from The Ottawa Hospital spearheaded the project, Feasibility & Initial Results of a Decision to Test Algorithm Using DASI in Operable Lung Cancer Patients.
Sarah Cuddy, MB, BCh, BAO; Yin Ge, MD, Ron Blankstein, MD, FASNC; Marcelo Di Carli, MD; Sharmila Dorbala, MD, MPH, FASNC (2017) – For their project, “Advanced Protocol Planning in Nuclear Cardiology to Enhance Care Delivery” at Brigham & Womens Hospital in Boston
Felix Krainski, MD, Besiana Liti, DO and William Lane Duvall, MD, MASNC (2016) – Drs. Krainski, Liti, and Duvall were selected as winners of ASNC’s Choosing Wisely Challenge for their submission “An Outpatient Pathway for Chest Pain Visits to the Emergency Department Reduces Length of Stay, Radiation Exposure and Is Patient-Centered, Safe and Cost-Effective” that proposed a novel testing algorithm for low-risk patients presenting to the emergency department.
American Urological Association
Mitchell Humphreys, MD, Peter Black, MD and Ithaar Derweesh, MD (2017) — As part of their participation in the AUA Leadership Program, Drs. Humphreys, Black and Derweesh conducted a membership survey focused on adherence to Choosing Wisely statements, with a focus on the AUA’s first list of recommendations, and worked with electronic medical record vendors to incorporate clinical decision support into systems to alert providers to the AUA’s recommendations.
Danil Makarov, MD (2016) – Dr. Makarov has conducted research on physician adherence to clinical practice guidance documents that demonstrate the need for educational tools to inform appropriate care.