Resource Stewardship Toolkit - for education of resident physicians

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Over the past year, I had the opportunity to contribute to the formation of several toolkits on the topic of "Resource Stewardship." These toolkits were created by the Royal College of Physicians and Surgeons of Canada (RCPSC) in partnership with Choosing Wisely Canada and the College of Family Physicians of Canada (CFPC).

The aim was to create modules that educators could use in order to encourage residents to be mindful of overdiagnosis, overtesting, and overtreating as they prepare for practice. By empowering them to have conversations with patients about unnecessary medical interventions and to undertake Quality Improvement projects in this area, preceptors can ensure that physician trainees satisfy the societal duty (as well as a residency education CanMEDS requirement) to be good stewards.

There are THREE toolkits, each containing a powerpoint and preceptor guide:

  1. Foundations - basic information, vocabulary to facilitate residents becoming mindful of considering the (broad) harms and benefits of any test, treatment, or procedure.
  2. Projects - information and guidance on how to undertake a scholarly (eg. research or QI) project in this area
  3. Communication - scenarios, role play, and other resources to help residents communicate with patients and families who may request an unnecessary test, treatment, or procedure

You can find more education resources on the teaching page.

Source: http://www.royalcollege.ca/rcsite/canmeds/...

Taking Action on Overuse: A Framework for Change (for Health Orgs & Institutes)

It has been a while since I discovered any new organizations doing work on the topic of overdiagnosis and the related issues of overtesting and overtreating. Many different projects and initiatives explore the subject; some, like Choosing Wisely, make lists of 'do not do' recommendations. Others, like Minimally Disruptive Medicine provide thoughtful reflection and model practices to show us how to burden our patients less and engage them more. The Lown Institute and their Right Care Alliance work at many levels, be it in political advocacy, cultural change, or clinical education. 

The Right Care Alliance is sponsored by the Robert Wood Johnson Foundation, something it has in common with Taking Action on Overuse.  While the former is more directed at patients, clinicians, and policy-makers, Taking Action on Overuse is a group that seems devoted to supporting health organizations and institutions. Organizations interested in creating changes to provide fewer unnecessary or harmful tests, treatments, and procedures, can employ the tools Taking Action has created. 

In their words, "Taking Action on Overuse is an evolving framework for health care organizations to engage their care teams in reducing low-value, unnecessary care and make those efforts last. It identifies evidence-based strategies for obtaining buy-in, motivating behavior changes, and providing the necessary support and infrastructure for health care providers to engage and lead their peers in making the changes that improve the value of health care."

Their Assessment can help you figure out whether your institution is ready with best practices, and gently guide you there. Likewise, their Framework can help you create the right conditions for change in a climate where many still believe "more is always better."

Check out their website here to learn more.

Source: https://takingactiononoveruse.org/

Quality Forum: Choosing Wisely by Jessica Otte on Prezi

10 minutes: That's how much time I had to tell the audience at the BC Quality Forum about the Choosing Wisely Canada campaign.

10 minutes may be the schedule duration of a routine patient visit with their GP. That's a short amount of time! In this short time it is hard to have a fulsome discussion with a patient about their condition, review their history, check in with their goals, and plan a strategy of treatment. It's even harder when the patient has 3 things they want to discuss!

10 minutes is not enough time to change the world - unless you do it a little bit at a time! That's why the take-away from my talk was simple:

If you feel you may need more, check out the slides on Prezi.

If you want to see other talks or articles I've done, go to the Media/Talks section.

Source: https://prezi.com/z0wgdfkmh64p/quality-for...