How are we implementing Choosing Wisely Manitoba?
Grassroots physician / practitioner engagement to set a foundation for culture change and system transformation
Integration of CWC into medical education curriculum to ensure that the new CanMEDS (especially physician leadership and resource stewardship) are taught to medical students and residents
Appointment of Executive Sponsors who have decision-making and financial authority to push initiatives forward across the province
Support and endorsement from Manitoba's Minister of Health
Strategic partnerships with key stakeholders and physician organizations
- Improving Preoperative Diagnostic Testing
- Tissues for Disposal
- Reducing Unnecessary Prostate-Specific Antigen (PSA) Testing
- Activated Partial Thromboplastic Time
- ESR and CRP Testing
- Appropriate Use of FOBT
- Improving the Appropriate Use of MRI for Lower Back Pain
- Appropriate Vitamin D Testing
- A Growing Momentum for Choosing Wisely
Improving Preoperative Diagnostic Testing
This project started with an examination of the barriers and facilitators to guideline adoption and implementation including further analysis of audit results, stakeholder consultations and a literature review. The results of this work were then used to develop and implement a new Routine Preoperative Lab Test Guideline. A series of interventions were then developed aiming first to reduce unnecessary testing in cataract surgery and then to reduce unnecessary testing in other types of surgery.
Tissues for Disposal
New standard operating procedures to eliminate testing from elective hip and knee replacement surgeries were developed and implemented at Concordia Hospital, Grace Hospital and Boundary Trails Health Centre. Now fully implemented at all provincial orthopedic surgery sites, the disposal of these tissues is freeing pathologists’ for other important work.
Reduction in pathology testing following the implementation of the new standard operating procedures.
Reducing Unnecessary Prostate-Specific Antigen (PSA) Testing
Many provinces in Canada along with the Canadian Urology Association, Canadian Cancer Society, Canadian Task Force on Preventive Health Care and Prostate Cancer Canada have recommendations around when men should have a PSA test to screen for prostate cancer. Most recommendations limit testing to within certain age parameters and risk factors.
Activated Partial Thromboplastic Time
Estimated reduction in aPTT test requests per month