Choosing wisely with our consumers and partner organisations

Initiative Type
Service Improvement
Status
Deliver
Added
21 August 2020
Last updated
04 September 2020

Summary

The success of Choosing Wisely relies upon active engagement of health consumers as well as health providers across the care continuum, so Sunshine Coast Hospital and Health Service (SCHHS) has built in these considerations into our governance processes.

Working hand in hand with our local Private Health Network and other partners and having not just one consumer representative on our committee but five, has broadened discussion, heightened staff awareness of the issues and also enacted real change in the ways we have approached the planning and implementing of our projects.

 

Key dates
Jan 2019
Implementation sites
Sunshine Coast Hospital and Health Service
Partnerships
consumers, clinicians, volunteers, the primary health network, clinical schools and support functions within the SCHHS

Aim

To work collaboratively with our consumers and partners to reduce treatment with limited evidence of overall benefit to consumer outcomes and experience.

Benefits

  • Enhanced communication between our consumers and health professional.
  • A health service that proactively partners with consumers and is responsive to their needs.
  • A culture that encourages continuous improvement and patient-centred care.
  • A data-driven, consumer-centred approach to improvement initiatives within the SCHHS.
  • A simple and cohesive process to enable out teams to identify, implement and sustain improvements with add value for our consumers.

Background

The Sunshine Coast Hospital and Health Service (SCHHS) has proudly been a Choosing Wisely champion health service since 2018. This means we are committed to helping patients and health professionals to make decisions together, improving care and reducing treatment that may be of limited overall benefit.

As an initial step, the SCHHS undertook a clinician perceptions survey and consumer perceptions survey. Findings indicated that:

  • 55.9% of clinician respondents indicated they had limited or no influence in reducing the use of tests, treatments and procedures of limited benefit
  • 86% of consumer respondents were not aware of the Choosing Wisely questions, and the top three barriers to asking questions of their doctor were; trust in doctors’ judgement, not believing the questions relate to their condition.
  • These results indicated the SCHHS had the opportunity to better involve patients in decisions about their care and reduce low benefit treatment.

Solutions Implemented

  • A hospital visit represents just one part of the care continuum, and so the SCHHS established a Choosing Wisely Faculty which comprised broad and enthusiastic representation.
  1. Sought members from key stakeholder groups
  2. Both from within the SCHHS and our partner organisations
  • Consumers are central
  1. Proactively sought consumer representatives.
  2. The Faculty included five consumers from the outset.
  • Executive sponsorship
  • Adoption of a quality improvement approach
  • Phased communication strategy

      1.    Awareness raising amongst staff
      2.    Community-focused awareness raising

  • Underpinned by the Hello my name is… initiative as means of starting the Choosing Wisely conversation.
  • Partnering with our volunteers to promote the Choosing Wisely resources to consumers.
  • Establishment of a Choosing Wisely improvement initiative fund, jointly funded with Wishlist (the SCHHS foundation).

 

 

Evaluation and Results

Qualitative results:

  • Tailoring of the Choosing Wisely Australia questions to ensure relevance and meaning to our consumers.
  • Incorporation of Choosing Wisely resources into Health Pathways for GP access.
  • Engagement with additional partners including the Junior Doctor Society, volunteers, and library services.
  • Enabling and focusing improvement projects amongst clinical teams.
  • Three initiatives funded from the inaugural Choosing Wisely improvement fund.

Quantitative results:

  • 36.1% of respondents to the 2018 baseline Consumer Survey strongly agreed that they feel confident to ask questions about tests being recommended for them. 2019 survey results indicated an increase to 41.0%.
  • Clinician awareness of the Choosing Wisely principles and recommendations increased from 29.1% in 2018 to 70.9% in 2020. This is above the 2020 target of 65%.
  • Clinical leads indicated that 70.5% of SCHHS-relevant Choosing Wisely Australia recommendations are embedded in business-as-usual or are being improved within SCHHS teams and services in 2020.
  • In addition to this, 37 improvements are underway in 2020, aligned with the Choosing Wisely principles rather than a specific college recommendation.

 

Lessons Learnt

  • Our consumers highlight the importance of getting the messaging right, inform our marketing material development, and identify areas for focus.
  • It is important to invite engaged clinicians who believed they could influence change, rather than force disinterested staff to participate.

 

References

Lindner, R.A. (2018). Choosing Wisely Australia: changing behaviour in health care, Medical Journal of Australia, 208(3), 105-106.
Moynihan, R., Barratt, A.L., Buchbinder, R., Cater, S.M., Dakin, T., Donovan, J., Elshaug, A.G., Glasziou, P.P., Maher, C.G., McCaffrey, K.J., & Scott, I.A. (2019). Australia is responding to the complex challenge of overdiagnosis, Medical Journal of Australia, 209 (8), 332-334.
Yu, K., Anstey, M., Cuthbertson, J., Jammali-Blasi, A., Melder, A., Toleman, J. & Lindner, R. (2019). Choosing Wisely in Australia hospitals: lessons from the field, Insight+, 10.

 

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Key contact

Megan Giles
Principal Advisor – Quality Improvement
Sunshine Coast Hospital and Health Service
07 5202 3085
sc-choosingwisley@health.qld.gov.au

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