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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
