University of Alberta




 Project Lead: Dr. Brian Rowe


Development, Implementation and Evaluation of the Impact of a Choosing Wisely Emergency List of Tests and Interventions for Emergency Departments in Alberta (PRIHS 2)


Emergency Departments (ED) are critical access points into the health care system for patients with acute illnesses and injuries. Increasing ED patient volume over the past two decades has impaired the capacity of health care workers to provide high quality care (e.g., timely, safe, effective, efficient, patient-centered, and equitable care). Delayed and prolonged care in the ED has been associated with adverse outcomes such as admission and death, and efforts to improve ED patient flow are urgently needed. ED management decisions, such as the ordering of diagnostic tests and treatments, are key factors associated with additional delays in
patient flow. These decisions are not always based on the best available scientific or cost-effective evidence. In addition, inappropriate or unnecessary tests or procedures may be harmful to patients’ health and safety. Using a stepped wedge randomized controlled trial design, this project will implement a variety of educational interventions across Alberta’s EDs, targeting both physicians and patients to reduce unnecessary diagnostic imaging. The project will focus on two demonstration areas: computed tomography head scans for patients presenting with benign headache and chest radiography for patients with acute asthma presentations.