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Local Initiatives

Choosing Wisely Manitoba is leading many quality improvement initiatives to introduce evidence-based changes and improvements to Manitoba’s health care system. Our goal is to improve appropriateness of care, patient and provider experience, health system efficiencies and sustainability by working with our healthcare stakeholders to build capacity for research stewardship and quality improvements projects that aim to reduce unnecessary tests, treatments and procedures in Manitoba.

How are we implementing Choosing Wisely Manitoba?

Knee MRI Appropriateness

Knee MRI Appropriateness

Shared Health Diagnostic Services is expanding our MRI Choosing Wisely initiative to include Knee MRI. This Clinical Practice Change and Guideline will require Primary Care Providers to include the Knee MRI Appropriateness Checklist when requesting Knee MRI exams. This will improve the appropriateness of MRI examinations across Manitoba, leading to standardized diagnostic workup prior to orthopedic referral for knee osteoarthritis. Using resources from Choosing Wiseley Canada, Shared Health has developed a short checklist that can verify or negate the indication for knee MRI. This approach is endorsed by the Arthroscopy Association of Canada – Part of the Canadian Orthopaedic Association – and the European Alliance of Associations for Rheumatology (EULAR).

In a 2024 internal audit, 1264 Manitoba Knee MRI requests were reviewed and 77% did not meet the criteria for appropriate MRI Imaging. With increasing demand for these services and increasing wait times, we are working to reduce low value testing, to improve outcomes and wait times for those most in need.

Resources:

Clinical Practice Change – Knee MRI Appropriateness Checklist

SH Clinical Practice Guideline – Knee MRI Appropriateness

F130-80-04A V01 Knee MRI Appropriateness Checklist

Patient Resource – Do you “Knee-d” a knee MRI?
Patient Resource – French – Avez-Vous Besoin D’une Irm Du Genou?

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