P071: Choosing Wisely in the emergency department: exploring the reach, support and potential for the Choosing Wisely Canada® campaign among emergency physicians. (15th May 2017)

• Record Type: Journal Article
• Authors: Krebs, L.; Chartier, L.B.; Holroyd, B.R.; Dowling, S.; Cheng, A.H.; Villa-Roel, C.; Campbell, S.G.; Couperthwaite, S.; Rowe, B.H.
• Is Part Of: CJEM. Volume 19(2017:May)Supplement 1
• Page Start: S102
• Page End: S102
• Publication Date: 2017-05-15
• Subjects: emergency department, -- Choosing Wisely Canada, -- implementation; Emergency Treatment -- Periodicals; Emergency Medicine -- Periodicals; Emergency medical services -- Canada -- Periodicals; Medical emergencies -- Canada -- Periodicals; Emergency medical services; Medical emergencies; Canada; Periodicals; 616.02505
• DOI: 10.1017/cem.2017.273
• Languages: English
• ISSNs: 1481-8035

Abstract

Abstract : Introduction: Choosing Wisely Canada® (CWC) launched in April 2012. Since then, the Emergency Medicine (EM) top-10 list of tests, treatments and procedures to avoid has been released and initiatives are on-going. This study explored CWC awareness and support among emergency physicians.Methods: A 60-question online survey was distributed to Canadian Association of Emergency Physicians (CAEP) members with valid e-mails. The survey collected information on demographics, awareness/support for CWC as well as physicians' perceived barriers and facilitators to implementation. Descriptive statistics were performed in SPSS (Version 24).Results: Overall, 324 surveys were completed (response rate: 18%). Respondents were more often male (64%) and practiced at academic/tertiary care hospitals (56%) with mixed patient populations (74%) with annual ED volumes of >50, 000 (70%). Respondents were familiar with campaigns to improve care (90%). Among these respondents, 98% were specifically familiar with CWC and 73% felt these campaigns assisted them in providing high-quality care. Respondents felt that the top-5 EM recommendations were supported by high quality evidence, specifically the first 4 recommendations (>90% each). The most frequently reported barriers to implementation were: patients' expectations/requests (33%), the possibility of missing severe condition(s) (20%), and requirements of ED consultations (12%). Potential facilitators were identified as: strong evidence-base for recommendations (37%), medico-legal protection for clinicians who adhere to guidelines (13%), and support from institutional leadership (11%).Conclusion: CWC is well-known and supported by emergency physicians. Despite the low response rate, exploring the barriers and facilitators identified here could enhance CWC's uptake in Canadian emergency departments.