choosing wisely in pediatric hospital medicine

Choosing Wisely in Pediatric Hospital Medicine

Jennifer Smitten, MD, FRCPC

BC Quality Forum 2017

A5: The Goldilock’s Principle: Providing Care That’s Just Right

Disclosures

• No conflicts of interest or commercial affiliations

What is quality health care?

The right care…

to the right patient…

at the right time…

in the right place.

V = –––––

Q

$ (VALUE)

(QUALITY)

(COST)

Choosing Wisely @ BC Children’s Hospital

Goal:

Reduce routine use of tests/treatments/procedures that

may be unnecessary, inappropriate, and/or harmful

Culture shift around evidence-based medicine

Teach quality care and resource stewardship

WHY?

Will this

change my

management?

How? Lessons learned so far…

• Be flexible

• Start small

• Teamwork

• Measurements…just do it!

How? Lessons learned so far…

• Be flexible

• Start small

• Teamwork

• Measurements…just do it!

How? Lessons learned so far…

• Be flexible

• Start small

• Teamwork

• Measurements…just do it!

How? Lessons learned so far…

• Be flexible

• Start small

• Teamwork

• Measurements…just do it!

(but get help)

Need to define a specific

aim

Use existing database(s)

Data support team

Challenges

• How to define “appropriate use”?

• Data collection

• Buy-in / stakeholder engagement in era of multiple

competing priorities

• Changing the status quo culture shift

Acknowledgements

• The Hudson Family

• Dr. Allison Eddy

• Mentors

• Dr. Jeremy Friedman

• Dr. Peter Skippen

• Collaborators

• Choosing Wisely Canada

• Drs. Peter Tilley & David Goldfarb

• Elodie Portales-Casamar, PhD

Thank you…questions / comments?

Get in touch!

Dr. Jennifer Smitten

jsmitten@cw.bc.ca

@jensmitten