Resources for Quality Improvement and Patient Safety
Choosing Wisely Consumer Report Patient-Friendly Educational Materials
Jamie Santistevan, MD
The Choosing Wisely campaign was launched by ABIM in 2012 with the goal of increasing patient and physician dialogue on the avoidance of unnecessary medical testing and treatments. ACEP has partnered with Choosing Wisely to generate 10 recommendations for emergency physicians.
- Avoid computed tomography (CT) scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules.
- Avoid placing indwelling urinary catheters in the emergency department for either urine output monitoring in stable patients who can void, or for patient or staff convenience.
- Don’t delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit.
- Avoid antibiotics and wound cultures in emergency department patients with uncomplicated skin and soft tissue abscesses after successful incision and drainage and with adequate medical follow-up.
- Avoid instituting intravenous (IV) fluids before doing a trial of oral rehydration therapy in uncomplicated emergency department cases of mild to moderate dehydration in children.
- Avoid CT of the head in asymptomatic adult patients in the emergency department with syncope, insignificant trauma and a normal neurological evaluation.
- Avoid CT pulmonary angiography in emergency department patients with a low-pretest probability of pulmonary embolism and either a negative Pulmonary Embolism Rule-Out Criteria (PERC) or a negative D-dimer.
- Avoid lumbar spine imaging in the emergency department for adults with non-traumatic back pain unless the patient has severe or progressive neurologic deficits or is suspected of having a serious underlying condition (such as vertebral infection, cauda equina syndrome, or cancer with bony metastasis).
- Avoid prescribing antibiotics in the emergency department for uncomplicated sinusitis.
- Avoid ordering CT of the abdomen and pelvis in young otherwise healthy emergency department (ED) patients (age <50) with known histories of kidney stones, or ureterolithiasis, presenting with symptoms consistent with uncomplicated renal colic.
To increase patient awareness on these topics, Consumer Reports has joined the effort by creating numerous patient-friendly educational materials. Here are links to relevant patient hand out materials that may facilitate the dialogue with patients to make them partners in their care.
For more patient-friendly resources on dozens of topics in English and Spanish, visit their website at: http://www.choosingwisely.org/patient-resources/