Choosing Wisely in Critical Care: National Survey Results

Abstract

Overview A component of precision medicine is aimed at providing individualized medical treatments for patients. However, over-utilization of tests, treatments, and procedures is common. Aims The purpose of this study was to assess how critical care clinicians were individualizing patient care and implementing Choosing Wisely® recommendations in clinical practice. Methods A descriptive survey methodology was used with Research Electronic Data Capture (REDCap). The survey, consisted of 6 questions assessing if the respondent was familiar with the Choosing Wisely® initiative and if so, what recommendations had been implemented in clinical practice. Results A total of 2,520 responses were received from nurses (61%, n=1538), physicians (25.9%, n=647), advanced practice providers (10.5%, n=263), and pharmacists (2.1%, n=52). Overall, 1,273 (50.6%) respondents were familiar with the Choosing Wisely® campaign. Respondents reported that Choosing Wisely® recommendations had been integrated in a number of ways including being implemented in clinical care (N=817, 72.9%), through development of a specific clinical protocol or institutional guideline (n=736, 65.7%), through development of electronic medical record orders (n=626, 55.8%), or with integration of longitudinal tracking using an electronic dashboard (n=213, 19.0%). Conclusions Conclusions: The results of this national survey identify the application of the Choosing Wisely® recommendations to clinical practice for critical care clinicians. As only half of the respondents report implementation, additional strategies are needed to promote the Choosing Wisely® recommendations to make impactful change to improve care in critical care settings.