September 1, 2020
Dr. Colin Peterson, Deputy Facility Medical Director at Royal Alexandra Hospital (RAH), wants staff and physicians at his site to ask themselves this question: “Does my patient really need this?” With his encouragement, the RAH has been recognized as the first hospital in Alberta to receive the Choosing Wisely Canada Level 1 designation, part of a global initiative that aims to inspire and engage healthcare professionals to take leadership in reducing unnecessary tests, treatments and procedures.
Story by Sharman Hnatiuk | Photo by Ken Dalton
Before they perform a medical test, treatment or procedure, Dr. Colin Peterson, Deputy Facility Medical Director at Royal Alexandra Hospital (RAH), encourages staff and physicians at his site to ask themselves this question: “Does my patient really need this?”
Last December, the RAH was recognized as the first hospital in Alberta to receive the Choosing Wisely Canada Level 1 designation. The Choosing Wisely global initiative aims to inspire and engage healthcare professionals to take leadership in reducing unnecessary tests, treatments and procedures — and enable them with simple tools and resources — making it easier to choose wisely.
As a lead for quality improvement at the RAH, Dr. Peterson says he’s determined to reduce unnecessary medical tests and treatments.
“When I trained as a resident years ago in the intensive care unit (ICU) it was standard practice for each patient to receive a chest X-ray every morning,” he says.
“We shouldn’t order or perform a test because it is routine; it has to serve a purpose. Since 2014, our physicians in the RAH ICU have reduced chest X-rays by 70 per cent by ensuring the test is ordered for patients only when clinically indicated.”
Choosing Wisely Canada estimates upwards of 30 per cent of medical tests, treatments and procedures in Canada are potentially unnecessary. This national movement also aims to highlight how decisions by physicians and care providers can potentially expose patients to harm, lead to more testing to investigate false positives, contribute to unwarranted stress for patients and their families and consume precious time and resources.
Choosing Wisely Canada shares free toolkits and implementation recommendations aimed at improving patient safety such as reducing inappropriate catheterization or pausing the draws on unnecessary blood work.
As an emergency department physician at the RAH, Dr. Peterson and his physician group helped reduce duplicate testing and legacy lab order sets as part of the five initiatives in the Choosing Wisely Level 1 implementation criteria.
While there is a sense of pride at the RAH for being the first in the province to receive the Level 1 designation, Dr. Peterson is quick to point out there are quality improvement champions helping implement actions aligned with Choosing Wisely at AHS hospitals and facilities across the province. If a site wants the designation, the next step is ensuring site leaders are onboard.
Dr. Peterson expects the RAH to achieve the Level 2 Choosing Wisely designation this fall; achieving Level 3 for the site will involve the RAH mentoring another AHS facility towards a Choosing Wisely designation.
“Patient safety and appropriate care is a priority for everyone at AHS; the Choosing Wisely initiative is just one way to help us achieve it.”