SGEM Xtra: High-Value Care Post Covid19 – Did you ever have to make up your mind?

Date: May 28th, 2021 Guest Skeptics: Heather Logan is the executive Strategy lead for the Canadian Agency for Drug and Technologies in Health (CADTH). Dr. Wendy Levinson is the Chair of Choosing Wisely Canada (CWC) and a Professor of Medicine, University of Toronto This SGEM Xtra is based on document created by CADTH and presented at Choosing Wisely Canada National annual meeting May 13, 2021. The title of the report is Using Health Care Resources Wisely After the COVID-19 Pandemic: Recommendations to Reduce Low-Value Care. We have discussed Choosing Wisely before on SGEM Episodes: SGEM#15: Choosing Wisely SGEM Xtra: CAEP Choosing Wisely SGEM Xtra: Right, You’re Bloody Well Right, You’ve got the Bloody Right to Care Choosing Wisely Canada (CWC): Dr. Wendy Levinson It is the national voice for reducing unnecessary tests and treatments in health care. One of its important functions is to help clinicians and patients engage in conversations that lead to smart and effective care choices. Choosing Wisely Canada is led by a team of clinicians and staff based at St. Michael’s Hospital (Toronto), the University of Toronto, and in collaboration with the Canadian Medical Association. Choosing Wisely Canada mobilizes and supports clinicians and organizations committed to embedding campaign recommendations into practice. There are close to 350 documented quality improvement projects across the country that are building capacity for the spread and scale of Choosing Wisely. These efforts are underway in hospitals, long-term care homes, and primary care clinics. Many of these innovative projects, including their evidence-based tools and methods, have been packaged into easy to follow toolkits that are broadly circulated in order to encourage widespread adoption. This has allowed Choosing Wisely Canada to foster a network for those looking to implement campaign recommendations into practice. Canadian Agency for Drug and Technologies in Health (CADTH): Heather Logan It is an independent, not-for-profit agency funded by Canadian federal, provincial, and territorial governments (except Quebec) to provide credible, impartial advice and evidence-based information about the effectiveness of drugs and other health technologies to Canadian health care decision-makers. CADTH believes that credible, objective evidence should inform every important health care decision. When you want to know what the evidence says, ask CADTH. Created in 1989 by Canada’s federal, provincial, and territorial governments, CADTH was born from the idea that Canada needs a coordinated approach to assessing health technologies. The result was an organization that harnesses Canadian expertise from every region and produces evidence-informed solutions that benefit patients in jurisdictions across the country. South Huron Hospital Association (SHHA) is known as the "Little Hospital that Does". SHHA has been choosing wisely since 2012 selecting five items every three years. SHHA Choosing Wisely 2012 Influenza shots for staff with privileges SGEM#20 Use Ottawa ankle and knee rules SGEM#3 and SGEM#5 No routine use of antivirals for Bell’s Palsy SGEM#14 No routine use of antibiotics for simple cutaneous abscesses SGEM#13 No routine use of proton pump inhibitors for upper GI bleeds SGEM#16 SHHA Choosing Wisely 2015 Utilize Canadian CT head rules to guide our decisions on getting CT heads SGEM#106 Utilize Canadian C-Spine rules to guide our decisions on obtaining plain film c-spine imaging SGEM#232 Do not do annual physical exams on asymptomatic adults with no significant risk factors Do not screen women with Pap smears if under 21 years of age or over 69 years of age Do not order echo cardiograms routinely SHHA Choosing Wisely 2018 Only use supplemental Oxygen for STEMI patients that are hypoxic (saturations < 90%) SGEM#...