Experience of Choosing Wisely in a Medical Center

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<p>明智選擇(Choosing Wisely)可以提高照護的品質、降低成本，避免醫療照護發生使用過度(Overuse)及使用不當(Misuse)的醫療品質或醫療爭議相關問題，使健保與醫療體系永續經營。高雄醫學大學附設中和紀念醫院於2020年啟動明智選擇推動專案，作為醫療適當性的檢討與改善機制。經首長宣示、建立推動架構、依任務分組、教育訓練及定時召開進度會議，再由醫品病安管理中心及實證醫學中心邀請並協助臨床科的選題及執行。共有7個團隊完成明智選擇主題，已舉辦成果發表會及跨院分享，並在各科開啟專業對話及醫療適當性的討論。藉由本院推動明智選擇的經驗分享，提升醫療的適當性，減少不必要的檢查、診斷或治療，可作為醫學教育及醫療先進的參考。</p> <p> </p><p>Choosing Wisely improves quality of care, reduces medical expenses, prevents overuse and misuse problems of medical care in relation to healthcare quality or medical disputes, and increases the sustainability of the National Health Insurance and medical systems. Since 2020, Kaohsiung Medical University Chung-Ho Memorial Hospital has promoted the Choosing Wisely program as part of the review and improvement mechanism for medical services to ensure their adequacy. Started up by the vice superintendent, we assigned tasks to relevant departments, executed educational programs and held regular meetings. With the assistance of the Medical Safety Management Center and Evidence-Based Medicine Center, we performed topic selection and implemented the Choosing Wisely program for seven clinical teams. All the teams completed the tasks successfully. We held a competition, presentation session, and experience-sharing meetings with other hospitals. The initiation of Choosing Wisely in our hospital enabled clinical professionals to participate meaningfully in peer discussion regarding the adequacy of medical care. Herein, we present our experience and strategies in promoting Choosing Wisely at our hospital, which improved the adequacy of medical services and reduced unnecessary testing, diagnoses, and treatments. This study may serve as a reference for those involved in medical education and medical professions.</p> <p> </p>