The 2020 Choosing Wisely® Challenge is now closed.

In light of the COVID-19 pandemic, HDSI will be selecting a Choosing Wisely project from one of our submissions to the COVID19 Innovation Challenge. 

Choosing Wisely® Challenge: Idea Incubator & Challenge

Around the world, the capabilities of modern medicine are being delivered inside of health systems with staggering complexity. Too often this complexity contributes to avoidable harm and unsustainable cost. Moreover, clinicians rarely have the support necessary to address preventable harm or deliver value–defined as the best possible care at the lowest possible cost.

To help address this gap, and mirroring the Costs of Care (an American nonprofit) and the ABIM Foundation, the University of Chicago Medicine (UCM) launched the Choosing Wisely® Challenge to identify and submit problems or issues observed by students, residents, fellows, and staff at UCM so they can develop promising bright improvement ideas for implementation at the medical center.  Previous winners of the Choosing Wisely® Challenge have received up to $5,000-$20,000 worth of staff time.

Case Example: Cost Framework Achieves Reductions

Choosing Wisely Challenge Themes 

The following themes were voted on by The Center for Healthcare Delivery Science & Innovation faculty.  All 5 themes were connected to the Annual Operating Plan (AOP) and 2 themes were connected to Choosing Wisely service recommendations.

  • Improving Employee Experience and Professional Development: examples include leadership training and employee benefits (AOP People)
  • Enhancing Patient Experience: examples include inpatient or ambulatory care (AOP Patient Experience)
  • Improving Testing (labs/radiology): examples include simplifying or automating processes or creating testing protocols (AOP Quality & Safety, Choosing Wisely recommendations)
  • Enhancing Communication and Coordination: examples include clinician-clinician or clinician-patient communication as well as workflow (AOP People)
  • Promoting EMR Optimization: examples include better assessment tools and more streamlined workarounds (AOP People)

Choosing WiselyTM Challenge

Instructions
1. Students, fellows, residents, faculty, and staff from any discipline may propose a solution for one of the five identified themes for a collaborative project that will add value to UCM in 500 words or less.  Special considerations will be given to teams that include interprofessional teams.

2. Please use the downloadable COST worksheet resource below to address the different elements in your submission

3. The Choosing Wisely Challenge Selection Committee, made up of medical center leadership, will select two winners to operationalize their solution. Winning projects will be announced at the Quality Safety Symposium on May 8, 2020.  Deadline: March 13, 2020

2019 Winners

Vanessa Buie

Improving Team Communication at the Bedside to Facilitate Early Discharge

Vanessa Buie, MD and Kelli Yukon, RN, supported by a multidisciplinary team
The project aims to implement a recently-developed “MD-in-Room” button to create an opportunity for the team to coordinate patient care needs, in order to facilitate early discharge.

choosing wisely 2019 Rearick Weber

Reducing Inappropriate Use of Outpatient Transthoracic Echocardiography

Corey Rearick, MD and Joe Weber, MD, supported by a multidisciplinary team
The project aims to educate staff and create Epic-based tools to inform when a TTE may not be clinically indicated. The project will compare TTE utilization, cost, and wait times before and after this campaign to determine efficacy.

2018 Winners

JAustin pic

Nebs No More After 24

Jennifer Austin, PharmD, supported by a multidisciplinary team
The project aims to optimize care transitions for applicable patients with COPD by switching from nebulized medications to metered-dose inhalers (MDIs) during their hospitalization via 1) BPA alert that will fire for all applicable floor patients who have received 24 hours of nebs and 2) training residents and hospitalists in the efficacy of MDIs and the appropriate parameters to change from nebs to MDIs.

David Cook pic

Reducing Excessive Nighttime Blood Pressure Monitoring in Hospitalized Children to Improve Pediatric Patient Experience

David Cook, Pritzker medical student, supported by a multidisciplinary team
The project aims to reduce excessive nighttime BP monitoring for selected pediatric patients for whom BP monitoring is not indicated via 1) implementation of EHR changes and 2) educational initiatives directed towards providers, nurses, and trainees.

2017 Winners

NTapaskar_CW_adjusted

Promoting Judicious Lab Orders

Natalie Tapaskar, MD, supported by a multidisciplinary team
A project that aims to encourage more thoughtful ordering of routine morning laboratory testing via 1) optimization of EPIC phlebotomy order sets and 2) education on hospital acquired anemia and sleep deprivation.

Jasmine taylor pic

Individualized Pain Plan for adolescent/young adult Sickle Cell patients

Jasmine Taylor, MD, supported by a multidisciplinary team
The project’s aim is to determine the feasibility of implementing Individualized Pain Plans in UCMC’s adolescent and young adult (AYA) sickle cell population (patients >/=18 with a Pediatric Hematology provider), and whether the introduction of individualized pain plans leads to an improvement in UCMC’s pain management in the AYA sickle cell population.

2016 Winners

An integrated approach to influenza vaccination for pediatric subspecialty patients

Emily Obringer, supported by a multidisciplinary team
A project that aims to ensure that every patient seen in Comer subspecialty outpatient clinics during influenza season (September 1 – March 31) has influenza vaccination status documented and to streamline the process of ordering and administering influenza vaccine to eligible patients.

SEE DIFF: Screening, Education, and Empowerment to Diagnose and Isolate C. diff

Chris Rishel, supported by a multidisciplinary team
A project that aims to provide clinical decision support to providers to 1) identify pre-existing infections and carriers within the first three days of admission, and 2) encourage mindful testing practices throughout the admission.

2015 Winners

Skip The Drips- Reining in unnecessary continuous intravenous infusions

Andy Levy, MD & Nikhil Bassi, MD
COLLABORATORS:
Matthew Sorrentino, M.D. (Section of Cardiology); J.P. Kress (Section of Pulmonology); Anna Zisman, M.D. (Section of Nephrology); K. Gautham Reddy, M.D. (Section of Gastroenterology); Emmanuel Coronel, M.D. (Fellow, Section of Gastroenterology); Sarah Sokol, PharmD (Clinical Pharmacy Specialist, Critical Care); Kristin Tuiskula, PharmD (Clinical Coordinator, Medication Safety)

Click here to read about this study published in JAMA Internal Medicine.

FLIP-ing the patient for discharge- How the bundling of Choosing Wisely recommendations through an EMR Dashboard can improve patient care

Charlie Wray, MD
COLLABORATORS:
Poushali Bhattacharjee, MD (Section of Hospital Medicine) and Aelef Worku, MD (Section of Hospital Medicine)

Honorable Mention

Default to Double-Sided Printing

Anand Gopalsami