Choosing Wisely®: Curbing The Use Of Ineffective & Costly Healthcare Through Nursing Lisa J. Hernandez, DNP, RN, CENP

Disclosures There are no financial disclosures to report. There is no conflict of interest. The information in this presentation will be given fairly and without bias.

Objectives Describe the Choosing Wisely® program goals and objectives. Discuss the aims of the Choosing Wisely® campaign. Identify two changes to nursing practice that will support the Choosing Wisely® campaign.

The Issue National focus on ways to provide safer, high-quality care to patients. Overuse of health care resources 30% of health care services are duplicative or unnecessary

Why Choosing Wisely®? The campaign is designed to help consumers and physicians: Engage in conversations about the overuse of tests, procedures and treatments To help health care consumers make smart and effective care choices

Choosing Wisely

Things Providers & Patients Should Know Participating organizations in the campaign created lists that: Include evidence-based recommendations That will stimulate discussions about the most appropriate care based on an individual’s unique situation.

Use of Recommendations Recommendations are NOT intended to establish coverage decisions or exclusions Recommendations ARE intended to spur patient-provider conversations Recommendations ARE intended to engage patients in determining the most appropriate treatment plan….together!

The Role of Consumer Reports Recognizing patients need better information, Consumer Reports has developed: Patient-friendly materials Is working with consumer groups to disseminate them widely Video series Other developments that market to health care providers and consumers: Smart Phone app development through Ringful Health- Choosing Wisely® in the palm of your hand!

An Important Milestone Engagement of the American Academy of Nursing in the Choosing Wisely® campaign represents an important milestone: Nurses are the most trusted profession by the patient population- (Gallup Poll) Patients rely on the advocacy of nurses to help them navigate increasingly complex health information.

American Academy of Nursing Through the Choosing Wisely® campaign, the American Academy of Nursing has developed the first nursing list of “Five Things Nurses and Patients Should Question”, with work progressing on additional lists of evidence-based recommendations. To promote conversations that will help consumers choose care that is: Supported by evidence; Not duplicative; Free from harm; and Truly necessary

AAN Recommendations for Nursing The recommendations are supported by: Extensive health evidence; Reviewed by Academy Fellows who are among the nursing profession’s most accomplished leaders The Academy is committed to leading the nursing professions’ efforts in the Choosing Wisely® campaign.

AAN Choosing Wisely

Additional Recommendations

Implications for Nursing Practice Nurses touch patients and consumers in multiple settings: Community Clinics Hospitals Health System Leadership Educational institutions

Nurses are Uniquely Positioned! Nurses are the most trusted by consumers….this means: Improved opportunities for relationship-based interventions; Improved opportunities for meaningful conversations and education at the point of care; Improved ability to participate in care coordination and patient advocacy activities.

Implications for Advanced Nursing Practice Advanced practice nurses serve patient needs across care settings; Advanced practice nurses and physicians provide collaborative care, designing treatment plans and care trajectories. Advanced practice nurses should be familiar with Choosing Wisely® lists from both the AAN and other societies that align with population and specialty area of practice focus.

Benefits for Consumers Triple Aim Results Improved patient engagement Improved patient-provider relationships Decrease in unnecessary care- better value at reduced cost Improved quality and safety of care received

The Role of IONL Leaders Advancing Health through Nursing- Leading collaborative health efforts; Leading change to advance health; Facilitating nursing practice to the full scope of education and training; Education and lifelong learning.

Important Websites

Happy! Choosing Wisely Makin' You Happy!

Questions

References Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group, (n.d.). National health expenditure projections 2010-2020. Retrieved from http://www.cms/gov/About- CMS/Agency-Information/CMSLeadership/Office_OACT.html Choosing Wisely website. (n.d.). http://www.choosingwisely.org Initiatives. (2014). (n.d.). http://www.ihi.org/engage/initiatives/tripleaim/pages/default.aspx