Implementing Choosing Wisely Canada Recommendations in Ontario to Improve Quality of Care: HQO Report

Ontario clinicians deliver quality care by reducing unnecessary care: new report When it comes to medical tests and procedures, less can sometimes be better. According to a new report released this week, Ontario health care providers are successfully working to provide and improve quality care by reducing unnecessary care to patients across Ontario. Released by Health Quality Ontario and Choosing Wisely Canada, the report, Spotlight on Leaders of Change: Implementing Choosing Wisely Canada Recommendations in Ontario to Improve Quality of Care, includes examples of successful programs implemented by clinical leaders to address unnecessary care in hospitals, primary and long-term care settings, including AFHTO member North York FHT. There is growing recognition that unnecessary care is common in health systems around the world, including Canada. The American-based Institute of Medicine estimates that up to 30% of medical care may be classified as unnecessary, at times introducing preventable risks associated with that care. Unnecessary care is defined as care in which there is a lack of benefit or in which benefits are outweighed by the potential risks, including patient inconvenience, increased cost to the health care system, and even potential harm to patients. Choosing Wisely Canada launched a national, clinician-led campaign in 2014 to help patients and clinicians talk more openly about tests, treatments and procedures so that they, and their families, can make informed choices about the care they receive. Over the last two years, Ontario researchers have worked with Health Quality Ontario and Choosing Wisely Canada to measure how common unnecessary care is in Ontario. This work has shown, for example, that 30% of Ontarians received potentially unnecessary cardiac tests and blood work before low risk, non-cardiac surgery. And, according to the report, unnecessary tests are not confined to hospitals. The report also notes that in primary care, 21% of Ontarians had bone mineral density testing not covered by practice guidelines. Reducing unnecessary care also saves money. Savings from ordering tests and procedures only when they are needed can be redirected to other needed patient care. Many clinicians in Ontario have contributed to the national effort to develop the Choosing Wisely Canada recommendations. Efforts in Ontario will now focus on how recommendations can be adopted. To learn more about the Choosing Wisely Canada recommendations being implemented by Ontario’s clinical community, read the full report.