Resource stewardship has taken on a different meaning for the clinicians and patients who live in the rural and remote communities in the Northwest Territories.  The decisions made around which tests and treatments are needed can have major implications for patients’ personal lives, and the health care system. For patients, a test may require medical travel that takes them away from their family, employment, support networks, and community. For clinicians, unnecessary ordering or travel to do a certain test can cause delays in patient care, and strain the limited health care resources.

Recognizing these challenges in NWT, Northwest Territories (NT) Health and Social Services Authority, working collaboratively with the NT Department of Health and Social Services, is excited to bring Choosing Wisely to the territory. Choosing Wisely NWT will focus on starting conversations about unnecessary tests and treatments and encourage smart and effective care choices.

In October, Choosing Wisely Canada Chair Dr. Wendy Levinson visited Yellowknife to learn more about how to apply the campaign to NWT’s health system. During the site visit, Dr. Levinson had the opportunity to gain an understanding of the unique environment and health care operations from various perspectives and assist in advancing a concrete plan for launching Choosing Wisely NWT.

NWT offers an exciting opportunity for Choosing Wisely Canada with a focus on collaboration between interdisciplinary teams. At the site visit, Dr. Levinson met with community nurses, administrators, physicians, and health system leaders who were motivated to helping spread the mission of the campaign. This clinical environment, which emphasizes interprofessional collaboration and team based care, is ideal for implementing and spreading campaign recommendations.  The enthusiasm from clinicians in NWT will also provide the momentum to move forward and tackle areas of overuse in the province.

In NWT, innovative strategies are being planned to implement the campaign in a remote and rural setting. For example, in NWT telemedicine and electronic health records are important tools to connect providers and patients across vast distances. Choosing Wisely NWT is considering opportunities to integrate campaign recommendations and information into such tools.

Those involved in planning the NWT launch have said they are excited about establishing a strong territorial Choosing Wisely Canada presence and communicating the importance of appropriate use of resources in a rural and remote setting. Choosing Wisely NWT is starting off with a focus on three clinical priority areas: reducing unnecessary antibiotic use, appropriate use of diagnostic imaging for lower back pain, and appropriate use of lab testing.

Choosing Wisely NWT is trailblazing the implication of campaign recommendations in rural and remote settings.  Our national community will look forward to learning from them and following their efforts! Stay tuned for the Choosing Wisely NWT launch in early 2018!