A Decade of Choosing Wisely Canada 

For the past ten years, Choosing Wisely Canada has been mobilizing frontline providers to make changes and curb overuse. In this conversation with co-founders, we reflect on the impact of Choosing Wisely Canada and look to the future of reducing overuse in Canadian health systems.

Speakers: 

• Dr. Wendy Levinson, Choosing Wisely Canada
• Tai Huynh, Choosing Wisely Canada

Learning Objectives:

• Describe the current state of overuse in Canada and efforts to address this complex problem in health care
• Illustrate successful examples from the past 10 years on driving change in health systems at local and national level
• Identify future opportunities to tackle overuse in health care

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Learn how to tackle overuse in your practice through hot topic sessions and abstract presentations featuring innovative approaches from across the country.

Addressing Low-Value Labs in Canada (EN)

Low-value lab testing has been a longstanding problem in Canada, straining hospital resources and potentially exposing patients to unwarranted investigations and treatments. This session will explore strategies to drive change in lab utilization, both at the frontline and system levels.

Dr. Adina Weinerman, General Internist, Sunnybrook Health Sciences Centre
Tasha Narain, Transition Lead, Strategic Projects, CADTH
Elizabeth Carson, Clinical Research Manager, CADTH

Learning Objectives:

• Learn about ways to reduce lab overuse in hospitals or health systems
• Describe examples of how implementation efforts have led to reductions in unnecessary lab testing
• Discuss new initiatives to create resources for hospitals and health systems to help curb lab overuse in Canada

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Shared Decision-Making in Primary Care (EN)

Dr. Janet Reynolds and Dr. Guylène Thériault will share the latest strategies and approaches to shared decision-making in primary care using examples from a recent implementation effort to embed serious illness conversations in practice.

Dr. Janet Reynolds, Family Physician and Primary Care Co-Lead, Choosing Wisely Canada
Dr. Guylène Thériault, Family Physician and Primary Care Co-Lead, Choosing Wisely Canada

Learning Objectives:

• Explain the importance of involving patients in decision-making in a context of overuse
• Identify potential barriers to effective communication about the risk of overdiagnosis/overuse
• Outline shared decision-making support tools to support conversations about unnecessary tests and treatments

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Abstracts on Choosing Wisely in Long-Term Care (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will share efforts to address overuse in long-term care settings.

Establishing an Antimicrobial Stewardship Program in Long-Term Care
Dr. Jessica Cuppage, Baycrest Health Sciences
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Reimagining LTC: Using Person-Centred Approaches for Appropriate Use of Antipsychotics
Joanna Burke-Bajaj and Neil Drimer, Healthcare Excellence Canada
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Tube feeding in Canadian Long-Term Care Residents with Advanced Dementia, 2006-2022
Dr. Luke Turcotte, Brock University

REACH LTC – REAssessing CHolinesterase inhibitors and memantine in Long-Term Care
Dr. Carolyn Tan, University of Toronto
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Learning Objectives:

• Describe efforts to reduce low-value tests and treatments in long-term care settings
• Illustrate successful examples of implementation efforts in long-term care settings
• Identify tools and resources that can support clinicians in reducing unnecessary testing and treatments in long-term care settings

Mobilizing the Next Generation to Choose Wisely (EN) 

Dr. William Silverstein will facilitate this session, where medical student leaders will showcase innovative approaches and strategies to engage learners in resource stewardship during training.

Dr. William Silverstein, General Internist, Sunnybrook Health Sciences Centre, STARS Lead, Choosing Wisely Canada

Learning Objectives:

• Recognize the importance of resource stewardship competencies in medical education
• Describe how to leverage medical student leadership in implementing Choosing Wisely initiatives
• Show examples of successful medical student leadership from across the country to advance resource stewardship initiatives

Docteur GPT: Allié ou cheval de Troie? (FR)

Cette session explorera les défis et les opportunités liés à l’utilisation de l’intelligence artificielle dans la pratique clinique.

Dre Pascale Breault, médecin de famille (Manawan et Montréal), professeure de clinique, Université Laval, directrice médicale au GMF-U du CLSC de Hochelaga-Maisonneuve

Objectifs d’apprentissage :

• Décrire l’histoire du développement des outils d’intelligence artificielle en médecine, notamment ceux ciblant les règles de décision clinique
• Expliquer le regard critique et éthique porté sur les enjeux liés à l’intégration de l’intelligence artificielle dans les dossiers électroniques des patients.
• Résumer les défis et les opportunités liés à l’utilisation de l’intelligence artificielle dans la pratique clinique

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Audio Presentation

Sustaining Change in Hospitals (EN)

Many hospitals embark on quality improvement projects to implement change and reduce overuse. However, sustaining these efforts long term can be challenging. This session will share practical guidance on how to effectively implement and sustain quality improvement initiatives to deliver high-quality care.

Dr. Christine Soong, Division Head of the Division of Hospital Medicine at Sinai Health and Hospital Designation Program Clinician Lead, Choosing Wisely Canada

Learning Objectives:

• Describe ways to implement Choosing Wisely in hospital settings
• Explain potential barriers and facilitators in driving and sustaining change in hospital settings
• Identify measurable quality metrics and indicators to assess the impact of Choosing Wisely implementation efforts

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Taking a Bite Out of Antibiotic Prescribing: Encouraging Antimicrobial Stewardship in Dentistry (EN)

Dental antimicrobial stewardship (AMS) has an important role to play in global efforts to tackle antimicrobial resistance. This workshop offers participants an opportunity to explore the challenges and opportunities of AMS in dentistry, providing potential strategies and tools to reduce unnecessary antibiotic prescribing.

Dr. Karen Born, Program Director, Institute for Health Policy, Evaluation and Management, University of Toronto
Dr. Christiana Martine, Researcher, Faculty of Dentistry, University of Toronto
Susan Taylor, Director, Quality, Royal College of Dental Surgeons of Ontario

Learning Objectives:

• Describe potential challenges and opportunities in dental antimicrobial stewardship efforts
• Discuss the development of educational tools and resources that help support antimicrobial stewardship in dental practice
• Identify potential strategies for engaging dentists in antimicrobial stewardship efforts

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Abstracts on Choosing Wisely and Climate Action (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature resource stewardship projects related to Choosing Wisely and climate action.

Reducing the Climate Impact of Rescue Inhalers for Asthma
Dr. Rosemarie Vincent, McGill University

Development of Canadian Critical Care Society Environmental Sustainability Choosing Wisely Canada Recommendations
Dr. Marko Balan, Memorial University of Newfoundland

“Desflurane needs to Des-appear”: Banning a Harmful Anesthetic Gas Across NL
Dr. Krista Mahoney, Memorial University of Newfoundland
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Learning Objectives:

• Recognize the important role clinicians play in leading change in the climate crisis
• Describe practical examples of environmentally sustainable initiatives to reduce overuse in practice
• Discuss tools and resources to support clinicians in implementing environmentally sustainable practice

Abstracts on Choosing Wisely in Pediatrics (EN)

This session will provide practical insights and approaches to integrating Choosing Wisely and resource stewardship in settings caring for children.

Less is Best: Creating a Bronchiolitis Toolkit for Change
Dr. Katie Gardner, Choosing Wisely Nova Scotia and IWK Health Centre

Supporting Parents to Choose Wisely: Randomized Trial and Qualitative Study
Dr. Sarah Elliott, University of Alberta

A two-step Pathway for Non-Invasive Urinary Tract Infection Screening
Dr. Nardin Kirolos and Dr. Andrea Rossos, University of Toronto
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Learning Objectives:

• Describe practice changes to reduce the overuse of tests and treatments in pediatric populations
• Describe effective approaches to integrating Choosing Wisely implementation efforts in pediatric settings
• Identify tools and opportunities to support clinicians in pediatric resource stewardship efforts

N’utilisez pas de bandelettes urinaires chez les personnes âgées (FR)

Cette séance discutera des outils et des stratégies pour l’utilisation appropriée de l’analyse d’urine dans les établissements de soins de longue durée.

Dr Jerome Leis, médecin responsable, Utilisation judicieuse des antibiotiques
Dre Agnès Cailhol, médecin de famille (présentant le Application sur téléphone intelligent pour déterminer la pertinence des analyses et cultures d’urine en CHSLD)

Objectifs d’apprentissage :

• Décrire les critères de Loeb et leur application pour déterminer la nécessité d’analyses et de cultures d’urine dans les établissements de soins de longue durée,
• Identifier les stratégies d’amélioration de la qualité pour encourager une utilisation appropriée de l’analyse d’urine dans les établissements de soins de longue durée
• Discuter des moyens potentiels d’identifier les obstacles et d’améliorer les analyses d’urine

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Using Blood Wisely (EN)

This session will provide valuable insights into leading blood stewardship efforts to protect this vital but limited health care resource, drawing on the experiences and lessons learned from three years of the Using Blood Wisely program.

Dr. Yulia Lin, Transfusion Specialist, Sunnybrook Health Sciences Centre and Using Blood Wisely Clinician Lead, Choosing Wisely Canada
Marie-Hélène Robert, Directeur Partenariat Clinique avec les Centres Hospitaliers, Héma-Québec

Learning Objectives:

• Discuss the successful implementation of a national blood stewardship program
• Highlight findings from three years of the Using Blood Wisely program on reducing inappropriate transfusion practices
• Discuss future opportunities to advance blood stewardship efforts in hospital settings

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Finding the Sweet Spot: Choosing Glycemic Control Wisely in Long-Term Care (EN)

Older adults with diabetes and frailty living in Canada’s long-term care homes are often treated counter to recommendations from evidence-based guidelines, increasing their risk for adverse outcomes. Clinicians face daily dilemmas regarding the roles of new monitoring technology and medications classes. This workshop will use clinical cases to explore these clinical uncertainties.

Dr. Andrea Moser, Family Physician Care of the Elderly, Associate Professor, University of Toronto
Dr. Iliana Lega, Scientist, Women’s College Research Institute and Staff Endocrinologist, Women’s College Hospital
Dr. Lisa McCarthy, Pharmacist and Associate Professor, University of Toronto

Learning Objectives:

• Highlight the evidence supporting new Canadian Society for Long-Term Care Medicine (CSLTCM) recommendations regarding avoiding sliding scale insulin and focusing on relaxed glycemic targets
• Discuss the role of new monitoring technologies and novel antihyperglycemic medication options for LTC residents
• Describe approaches for having conversations with residents and families regarding goals of diabetes care

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Abstracts on Reducing Unnecessary Testing (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature implementation and measurement efforts on unnecessary testing in hospitals.

Use of Routine Bloodwork on General Internal Medicine Inpatients: A Retrospective Cohort Study
Dr. William Silverstein, Sunnybrook Health Sciences Centre

Reduction of Unnecessary Routine CBC Testing After Cesarean Deliverys
Dr. Yannay Khaikin, University of Toronto
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Reducing Unnecessary Thyroid Function Testing Through Optimizing Test Ordering Protocols
Dr. Joel Scott, University of Saskatchewan

Sources of Variability and Unnecessary Blood Testing in the Intensive Care Unit
Dr. Thomas Bodley, University of Toronto

Learning Objectives:

• Describe efforts to reduce low-value tests in hospital settings
• Illustrate successful examples of implementation efforts in hospital settings
• Identify tools and resources that can support clinicians in reducing unnecessary testing and treatments in hospitals

Innovations Choisir avec soin (FR

Les résumés présentent des initiatives Choisir avec soin et des approches innovantes de partout au pays. Cette session présentera des projets liés à la réduction de la surutilisation et à l’amélioration des pratiques.

Pour une pratique éclairée : une formation sur l’utilisation judicieuse de ressources en soins primaires
Dr Samuel Boudreault, médecin de famille (Joliette), directeur du programme de médecine familiale, Université Laval

Portrait de la polypharmacie et de l’usage de médicaments potentiellement inappropriés chez la personne âgée au Québec
Marie-Pierre Rousseau et Rodolphe Jantzen, INESSS

Campagne sur le traitement non-pharmacologique de l’insomnie
Dr Pierre Luc Thériault
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Comment la pratique avancée en physiothérapie optimise le parcours clinique vers l’orthopédie et la neurochirurgie 
Marjorie Gingras et Valérie Chevrette, Association Québécoise de la Physiothérapie (AQP)
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Objectifs d’apprentissage :

• Décrire des exemples pratiques d’initiatives visant à réduire la surutilisation dans la pratique
• Discutez des outils et des ressources pour aider les cliniciens à mettre en œuvre Choisir avec soin

Dépister avec soin : Intégrer la décision partagée (FR)

Cette séance discutera des pratiques appropriées en matière de dépistage et des stratégies de communication pour discuter des avantages et des risques du dépistage.

Dre Geneviève Bois, médecin de famille (Whapmagoostui), professeure adjointe, Université de Montréal

Objectifs d’apprentissage :

• Identifier les bonnes pratiques entourant le dépistage
• Discuter des zones d’incertitudes en ce qui concerne le dépistage
• Communiquer les bénéfices et risques en dépistage

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A Primer on Using Data to Demonstrate Improvement (EN)

Teams implementing Choosing Wisely improvement projects need to determine whether they have successfully reduced unnecessary tests and treatments. Knowledge of fundamental principles in managing and analyzing data, in particular time-series techniques such as run and control charts commonly used in quality improvement, allows teams to add a rigorous approach to evaluating their Choosing Wisely improvement projects.

Dr. Brian Wong, General Internist, Sunnybrook Health Sciences and Director of the Centre for Quality Improvement and Patient Safety (CQuIPS)

Learning Objectives:

• Differentiate between different types of data used for quality improvement
• Describe the advantages of using run and control charts for Choosing Wisely improvement projects
• Interpret run and control charts to determine whether improvement has occurred

4E’s Ways to Reduce Low-value Care on Medical Wards (EN)

This workshop will focus on effective interventions to reduce overuse of urinary catheters, routine and repetitive bloodwork, and continuous telemetry monitoring in medical wards. Facilitators will discuss evidence-based strategies, epidemiology of overuse, documented harms of inappropriate care, and quality improvement initiatives that can help reduce these common low-value care practices.

Dr. William Silverstein, General Internist, Sunnybrook Health Sciences Centre and STARS Lead, Choosing Wisely Canada
Dr. Jerome Leis, Infectious Disease Physician, Sunnybrook Health Sciences Centre and Using Antibiotics Wisely Lead, Choosing Wisely Canada

Learning Objectives:

• Describe evidence-based indications for three common forms of low-value care in medical wards
• Discuss documented harms and epidemiology of overuse
• Summarize quality improvement initiatives that can reduce provision of these forms of inappropriate care

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Abstracts on Medication Appropriateness (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature projects on medication appropriateness and deprescribing.

The Cost Of Potentially Inappropriate Medications in Canada: A Comparative Cross-Sectional Study
Dr. James Silvius, Canadian Medication Appropriateness and Deprescribing Network

Decolonizing Medication Appropriateness: Charting a Path Towards Indigenous Health Equity
Dr. Larry Leung, University of British Columbia
Amber Ruben, Misericordia Community Hospital
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Pharmaceutical Automated Reporting: An Opioid Stewardship Tool
Dylan Turner, Regina General Hospital, Saskatchewan Health Authority
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Electronic Deprescribing With Patients on Hemodialysis : A Quality Improvement Study
Émilie Bortolussi-Courval, McGill University
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Learning Objectives:

• Describe efforts to reduce inappropriate prescribing in practice
• Illustrate successful examples of implementation efforts to decrease inappropriate prescribing
• Identify tools and resources that can support clinicians in deprescribing practices

Enseigner avec soin : comment aider les apprenants à intégrer une gestion pertinente des ressources dans leur pratique (FR)

À travers des histoires de cas, cette session explorerons comment intégrer les principes d’une utilisation judicieuse des tests et des traitements dans nos enseignements.

Dre Guylène Thériault, médecin de famille (Gatineau), coresponsable des soins primaires pour Choisir avec soin Canada
Dre Victoria Blouin, Résidente en chirurgie orthopédique

Objectifs d’apprentissage :

• Utiliser différents outils pour guider les apprenants dans leur réflexion sur l’utilisation judicieuse des ressources
• Guider les apprenants face aux demandes qui peuvent ne pas être concordantes avec une utilisation judicieuse des ressources
• Ouvrir une discussion sur les tests et traitements non nécessaires

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Examiner avec soin : les manoeuvres de l’examen physique les plus discriminantes (FR)

Dre Geneviève Bois, médecin de famille (Whapmagoostui), professeure adjointe, Université de Montréal

Objectifs d’apprentissage :

• Appliquer de manière clinique les différentes valeurs statistiques associées aux manoeuvres de l’examen physique
• Reconnaître la faible valeur ajoutée de tests de l’examen physique et déterminer la pertinence clinique
• Optimiser l’examen physique en utilisant des manœuvres de l’examen physique qui sont plus discriminantes

Medication Appropriateness in Canada 

Medication prescribing is one of the most common activities in clinical practice. However, the issue of overuse and inappropriate prescribing poses significant challenges in health care. Expert speakers from hospitals, long-term care, and primary care settings will discuss the current landscape and future of prescribing practices in Canada.

• Dr. Barbara Farrell, Scientist, Bruyère Research Institute
• Dr. John Hirdes, Professor, School of Public Health and Health Sciences, University of Waterloo
• Dr. Emily McDonald, Associate Professor of Medicine, McGill University, and Scientific Director, Canadian Medication Appropriateness and Deprescribing Network

Learning Objectives:

• Identify common drivers and barriers in medication appropriateness across primary, long-term care, and hospital sectors
• Illustrate successful implementation examples to address common drivers of overuse
• Discuss potential strategies to advance medication appropriateness across sectors

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Abstracts on Change at the System Level (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature projects on how to implement change across health systems.

Integration of  “Choosing Wisely” in a Healthcare Network
Dr. Eric Levasseur and Dr. Ihssan Bouhtiauy, Vitality Health Network

Creating a Learning Health and Social System in Newfoundland & Labrador
Dr. Krista Mahoney, Memorial University of Newfoundland
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Lessons Learned Implementing at Provincial Scale
Christine Peters, Shared Health

Learning Objectives: 

• Explain system-level initiatives aimed at reducing overuse.
• Describe the implementation strategies and common barriers for large scale implementation
• Describe methods to translate these insights into practical applications within various practice settings

Patient Involvement from Start to Finish: Meaningful Patient Engagement in De-implementation Initiatives (EN)

This session aims to provide practical resources for co-designing a de-implementation research study with patients and researchers. These resources and ‘how-to’ examples are not limited to research and will be useful to anyone working with patients and the public in their de-implementation efforts.

Stefanie Linklater, Research Program Manager, Ottawa Hospital Research Institute
Dr. Holly Etchegary, Associate Professor Faculty of Medicine Academic, and Patient Engagement Lead CIHR-SPOR NL SUPPORT, Memorial University
Gloria Wilkinson, Patient Advisor, De-Implementing Wisely Team

Learning Objectives: 

• Illustrate the role of patient collaboration in research and de-implementation efforts
• Identify potential opportunities for integrating patients into research and quality improvement initiatives
• Explore best practices and approaches for effective patient engagement

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Serious Illness Conversations: After Theory, Let’s Practice! (EN)

Serious illnesses place people at risk of receiving treatments that may not benefit them and that poorly reflect their goals and values. This workshop will introduce participants to tools to identify patients at high risk of mortality and provide an opportunity to practice, with guidance and coaching, a patient-tested serious illness conversation.

Dr. Maxine Dumas Pilon, Family Phyisician and Assistant Professor Department of Family Medicine, McGill University
Dr. Stefanie Gingras, Palliative Care Physician, McGill University Health Centre
Dr. Sonia Skamene, Radiation Oncologist and Assistant Professor at McGill University

Learning Objectives: 

• Describe the role of serious illness conversations in improving patient care and preventing potentially harmful or aggressive treatments, emphasizing evidence-based approaches
• Explore tools to incorporate serious illness conversations in practice
• Identify potential strategies for implementing serious illness conversations in practice

Abstracts on Reducing Overuse and Our Carbon Footprint (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature initiatives tackling waste, harm, and our carbon footprint.

Reducing Waste Associated with Thoracentesis and Paracentesis on the CTU
Dr. Alice Yu, The Ottawa Hospital

Reducing the Impact of MDIs on Emergency Department Carbon Emissions
Candis Lepage, Dalhousie University
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Environmentally Sustainable Opportunities for Health Systems: Metered-Dose Inhaler Prescribing, Dispensing, Usage and Waste at The Ottawa Hospital
Shellyza Sajwani, The Ottawa Hospital

Learning Objectives: 

• Recognize the important role clinicians play in leading change in the climate crisis
• Describe practical examples of environmentally sustainable initiatives to reduce overuse in practice
• Discuss tools and resources to support clinicians in implementing environmentally sustainable practice

Investiguer avec soin : reconnaître les examens de laboratoires inutiles (FR)

Découvrez les risques liés à la surutilisation des tests de laboratoire en soins primaires et apprenez à faire des choix éclairés. Participez à notre atelier pour mettre en pratique les recommandations de Choisir avec soin et examiner les preuves de 20 tests de laboratoire.

Dr Samuel Boudreault, médecin de famille (Joliette), directeur du programme de médecine familiale, Université Laval

Objectifs d’apprentissage :

• Énumérer les facteurs expliquant la prévalence des soins de faible valeur, ainsi que leurs conséquences
• Identifier des investigations à faible valeur ajoutée mais encore couramment utilisées
• Adopter des stratégies de communication afin de freiner la surutilisation

Ditch the Dipsticks in Older Adults (EN)

Dipsticks in older adults and long-term care residents are positive over 80% of the time. In clinical practice, these positive results are equated to the presence of urinary infection even in the absence of compatible presentation, prompting unnecessary urine cultures, antibiotics, or both, and leading to increased risks, including antibiotic resistance. This session will explore the barriers to change and share practical solutions to address this overuse problem across both long-term care and acute care sectors.

Dr. Jerome Leis, Infectious Disease Physician, Sunnybrook Health Sciences Centre and Using Antibiotics Wisely Lead, Choosing Wisely Canada

Learning Objectives: 

• Describe evidence supporting de-adoption of urinalysis and urine dipsticks for older adults (over the age of 65)
• Discuss importance of a unified approach across different health care sectors
• Identify strategies to successfully de-adopt these tests across both long-term care and acute care settings

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Advancing Quality Improvement to Reduce Overuse, Advance Quality & Environmental Sustainability (EN)

This workshop will share how sustainability, reducing overuse and advancing quality of care in health systems are intricately linked. It will identify sustainability co-benefits in the practices and projects that are already being implemented to reduce overuse and advance quality.

Dr. Karen Born, Institute for Health Policy, Evaluation and Management, University of Toronto
Dr. Nicole Simms, Executive Lead and Training and Education Lead, CASCADES

Learning Objectives: 

• Situate environmental sustainability as a pre-requisite, goal, and outcome of high-quality care across all domains of quality
• Examine strategies to incorporate climate-relevant objectives and measures in quality improvement projects
• Review QI projects focused on reducing overuse that have focused both directly and indirectly on reducing the environmental impacts of care

Abstracts on Imaging and Testing Wisely (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature initiatives tackling unnecessary imaging and low-value testing.

Utility and Practices of Routine Post Cardiac Surgery Testing in Adult Patients
Dr. Marko Balan, Memorial University of Newfoundland
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Canadian Association of Radiologists Diagnostic Imaging Referral Guidelines
Dr. Candyce Hamel, Canadian Association of Radiologists
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Developing an Intervention for Implementing Low Back Pain Choosing Wisely Recommendations
Véronique Lowry, Université de Montréal
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Learning Objectives: 

• Describe efforts to reduce inappropriate imaging
• Illustrate successful examples of implementation in reducing unnecessary imaging
• Identify tools and resources that can support the reduction of unnecessary imaging tests

Choisir avec soin et action climatique (FR)

Cette séance discutera de la réduction de la surutilisation et de la manière dont cela profite aux patients et à la planète.

Dre Maxine Dumas Pilon, Département de médecine de famille, Université McGill
Dre Rebecca Bourgault, Collège Québecois des Médecins de Famille (CQMF)
Dre Caroline Laberge, Professeur agrégée de clinique, GMF-U Laurier, Université Laval

Objectifs d’apprentissage :

• Reconnaître le rôle de Choisir avec soin dans la durabilité environnementale
• Décrire des approches pratiques pour intégrer la durabilité environnementale dans différents contextes de pratique

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Au-delà de l’AMM, comment changer la trajectoire de fin de vie des patients atteints de troubles neuro-cognitifs pour leur permettre de mourir dans la dignité (FR)

Dre Géraldine Lachance-Fortin, médecin de famille, CSSS Côte de Gaspé

Objectifs d’apprentissage :

• Connaître l’évolution naturelle des troubles neuro-cognitifs
• Explorer les données probantes en matière de prévention des troubles neuro-cognitifs
• Questionner l’éthique des soins curatifs à tout prix, sur le plan individuel, systémique et social
• Repérer des opportunités de discuter des objectifs de soins et de mourir de causes naturelles tout au long de la trajectoire des patients atteints de de troubles neuro-cognitifs et dans différents contextes cliniques (suivi de patients, urgence, hospitalisation et soins de longue durée)

Choosing Wisely for Health on a Grand Scale

• Dr. Jane Philpott, Dean of Medicine, Queen’s University

Learning Objectives:

• Construct new models for improving access to primary health care
• Formulate a transition plan to achieve better value for money in health systems

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Choosing Wisely in Long-Term Care: Introducing a New National Program (EN)

Choosing Wisely Canada is gearing up for the launch of a new national program to tackle potentially inappropriate medication use in long-term care (LTC) settings. This session will explore the current state of medication use, potential improvement strategies, and how LTC facilities can get involved.

Dr. Sid Feldman, Long-Term Care Clinician Co-Lead, Choosing Wisely Canada and Executive Medical Director, Residential Programs, Baycrest Health Sciences,
Julie Weir, Long-Term Care Clinician Co-Lead, Choosing Wisely Canada and CEO, New Brunswick Association of Nursing Homes

Learning Objectives: 

• Describe a national program that aims to decrease inappropriate medication use in long-term care settings
• Explain current trends and barriers to reducing inappropriate medication use
• Discuss potential implementation and improvement strategies to reduce inappropriate medication use

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Using Facilitated Audit & Group Feedback to Implement CWC Recommendations (EN)

The Calgary Audit and Feedback Framework (CAFF) is a practical, theory informed approach developed and used by the Physician Learning Program to facilitate interaction and engagement with clinical teams in planning and implementing change.. The workshop will provide attendees with real-world examples of using CAFF to develop and implement CWC recommendations.

Dr. Kelly Burak, Physician Learning Program, University of Calgary
Dr. Eliana Castillo, Physician Learning Program, University of Calgary

Learning Objectives: 

• Summarize the evidence for audit and feedback
• Discuss real-life examples using facilitated audit and group feedback to implement CWC recommendations
• Participate in group-based interactive exercises to practice facilitation techniques and how to optimize these for in-person and online sessions

Abstracts on Choosing Wisely in Hospitals (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature projects on Choosing Wisely in hospitals.

Don’t delay Palliative Care – Real-world Cancer and Palliative Care Integration
Dr. Jessica Simon and Dr. Aynharan Sinnarajah, Alberta Health Services
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Reducing Unnecessary Urine Drug Screen Testing in the ED
Dr. Jason Vanstone, Saskatchewan Health Authority
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Reducing Urinary Catheterization Rates with Behavioural Interventions
Dr. Nathan Wilson, Memorial University
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Learning Objectives: 

• Describe efforts to reduce low-value tests in hospital settings
• Illustrate successful examples of implementation efforts in hospital settings
• Identify tools and resources that can support clinicians in reducing unnecessary testing and treatments in hospitals

Discuter de maladies graves: Comment aborder les niveaux de soins (FR)

Cette présentation adresse les différentes connaissances nécessaires pour se sentir à l’aise dans une discussion de niveau de soin et divers trucs de communication.

Dre Mireille Aylwin, médecin de famille, Hopital et CLSC de Verdun

Objectifs d’apprentissage :

• Maitriser les informations pertinentes à la discussion sur la réanimation cardio-vasculaire
• Reconnaître les limites des outils communicationnels et de la documentation des NIM
• Discuter la pertinence de la discussion des objectifs de soins dans plusieurs contextes de pratique : soins urgents, soins semi-urgent, suivi longitudinal (bureau, clinique), CHSLD
• Intégrer l’utilisation de formulations qui favorisent la discussion avec les patients et leurs proches

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Investiguer avec soin : reconnaître les examens d’imagerie inutiles (FR)

À travers cet atelier, les participants appliqueront les recommandations de Choisir avec soin et évaluerons les données probantes concernant l’usage d’imagerie dans les cas de céphalée, commotion cérébrale, délirium, douleur lombaire, douleur au genou, hernie inguinale et mastalgie.

Dre Guylène Thériault, médecin de famille (Gatineau), coresponsable des soins primaires pour Choisir avec soin Canada
Dre Pascale Breault, médecin de famille (Manawan et Montréal), professeure de clinique, Université Laval, directrice médicale au GMF-U du CLSC de Hochelaga-Maisonneuve

Objectifs d’apprentissage :

• Prescrire l’imagerie cérébrale de manière appropriée dans les cas de céphalée, commotion cérébrale et délirium
• Utiliser les examens d’imagerie de manière judicieuse pour investiguer les plaintes musculosquelettiques concernant le dos et le genou
• Réfléchir à l’usage judicieux de l’imagerie afin de réduire les incidentalomes

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Choosing Wisely Canada would like to thank the following organizations for their generous support of this year’s event. Choisir avec soin remercie les organisations suivantes pour leur généreux soutien à l’événement de cette année.

• Centre for Effective Practice
• ISMP Canada
• Sleepwell.ca
• Choosing Wisely Quebec