<i>CJEM</i> Debate Series: #ChoosingWisely – The Choosing Wisely campaign will not impact physician behaviour and choices

Atkinson, Paul; Lang, Eddy; Mackenzie, Meaghan; Hiranandani, Rashi; Lys, Rebecca; Laupacis, Megan; Murray, Heather

doi:10.1017/cem.2017.402

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…Forty-eight percent of respondents replied that being able to get an appointment quickly was important to 16 them, and 44% noted that going to a doctor who spends enough time with them was critical. Thirty-four percent of respondents listed a short waiting time in the doctor's office as one of their three most important requirement [24].…”

Section: Waiting Timementioning

confidence: 99%

Evaluating Patients’ Level of Satisfaction on the Quality of Health Services in Ekiti State University Teaching Hospital, Ado-Ekiti Nigeria

Bamise

Agbele

Adebayo

2021

AJMAH

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Aims: To evaluate patients’ level of satisfaction on the quality of healthcare received by focusing on waiting time due to its level of importance. Studies have shown that a good healthcare system contributes immensely to the growth of a thriving economy, because patients’ satisfaction is the major indicator of quality healthcare. Study Design: A descriptive cross-sectional study was employed by using a structured questionnaire coupled with interview session. These was considered appropriate for data gathering in the overall outpatient department (OPD) of the health facility. Methods: The present study evaluates patients’ satisfaction level on the QoS in Ekiti State University Teaching Hospital (EKSUTH), Nigeria; by focusing majorly on waiting time. Systematic random sampling technique was used in selecting the participants for this research, with 241 patients’ data collected. Convenience, courtesy and quality of care were used as factors to measure patients’ satisfactions. Results: Findings from this study showed that 73.03% of the patients were satisfied with the level of services in terms of conveniences, while 80.50% of the patients were highly satisfied as regards the courtesy level, also, 77.59% of the patients were satisfied with the quality of care received at the facility. Furthermore, our result indicates that a total of 154 (63.9%) of the patients were greatly satisfied with the quality of health services received in EKSUTH, however, 87 which represents 36.1% of patients were not satisfied with the level of services rendered at the facility. Conclusion: The respondents showed high satisfaction level in most of the services they received from EKSUTH, however, long waiting time in the health facility has shown to be an impediment to the satisfaction level as well as the quality of care (QoC) received. Therefore, improved services; especially reducing the long waiting time will motivate patients to continue to utilize EKSUTH. More so, continuous efforts should be made by the hospital’s administration to improve other areas where satisfaction level was shown to be low in the present study.

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Section: Waiting Timementioning

confidence: 99%

Evaluating Patients’ Level of Satisfaction on the Quality of Health Services in Ekiti State University Teaching Hospital, Ado-Ekiti Nigeria

Bamise

Agbele

Adebayo

2021

AJMAH

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“…Compelling evidence reveals that some waste can be minimized. However, the simple awareness of these Top-5 Recommendations Lists are insufficient to change physician behaviors [18]; other factors influence their practice, which is why these campaigns have only modest success [19,20]. Several factors represent a barrier to implementing the Less is More approach (Fig.…”

Section: Barriers To Reducing Overusementioning

confidence: 99%

The challenge of implementing Less is More medicine: A European perspective

Kherad

Peiffer-Smadja

Karlafti

et al. 2020

European Journal of Internal Medicine

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The concept of Less is More medicine emerged in North America in 2010. It aims to serve as an invitation to recognize the potential risks of overuse of medical care that may result in harm rather than in better health, tackling the erroneous assumption that more care is always better. In response, several medical societies across the world launched quality-driven campaigns ("Choosing Wisely") and published "top-five lists" of low-value medical interventions that should be used to help make wise decisions in each clinical domain, by engaging patients in conversations about unnecessary tests, treatments and procedures.However, barriers and challenges for the implementation of Less is More medicine have been identified in several European countries, where overuse is rooted in the culture and demanded by a society that requests certainty at almost any cost. Patients' high expectations, physician's behavior, lack of monitoring and pernicious financial incentives have all indirect negative consequences for medical overuse. Multiple interventions and quality-measurement efforts are necessary to widely implement Less is More recommendations. These also consist of a top-five list of actions: (1) a novel cultural approach starting from medical graduation courses, up to (2) patient and society education, (3) physician behavior change with data feedback, (4) communication training

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“…The Canadian Cardiovascular Society's clinical practice guidelines 9 and Choosing Wisely Canada's clinical recommendations 10 are evidence-based campaigns to support appropriate screening and diagnostic testing in cardiology, but there are various reasons they might not be followed when indicated. [11][12][13] Pitfalls in clinical decision-making, such as cognitive biases or lack of knowledge, could lead to diagnostic errors and test underuse. 14,15 Conversely, lack of knowledge or incidental findings might trigger a cardiology workup and test overuse.…”

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confidence: 99%

Medico-Legal Cases Involving Cardiologists and Cardiac Test Underuse or Overuse

et al. 2021

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Background: Evidence-based campaigns are available to support appropriate diagnostic testing in cardiology, but medico-legal concerns can impede implementation. Methods: We conducted a retrospective descriptive analysis of medico-legal cases (civil legal, regulatory authority, hospital matters) involving cardiologists in Canada. For eligibility, cases must have closed at the Canadian Medical Protective Association between January 1, 2009 and December 31, 2018. We defined test underuse and overuse using criticisms in the medico-legal record from peer experts, regulatory authorities, or hospitals. We used a contributing factors framework and descriptive statistics for analysis.

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CJEM Debate Series: #ChoosingWisely – The Choosing Wisely campaign will not impact physician behaviour and choices

Cited by 9 publications

References 33 publications

Evaluating Patients’ Level of Satisfaction on the Quality of Health Services in Ekiti State University Teaching Hospital, Ado-Ekiti Nigeria

Evaluating Patients’ Level of Satisfaction on the Quality of Health Services in Ekiti State University Teaching Hospital, Ado-Ekiti Nigeria

The challenge of implementing Less is More medicine: A European perspective

Medico-Legal Cases Involving Cardiologists and Cardiac Test Underuse or Overuse

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