Recently, Mount Sinai Hospital, part of Sinai Health, became recognized as a Choosing Wisely Canada Hospital in the Leadership Status level— the highest achievement awarded under the national program. This designation recognizes Sinai Health’s commitment to quality improvement, with Dr. Christine Soong, Medical Director, Quality and Safety and Division Head of Hospital Medicine at Sinai Health, playing a pivotal role in the success. Dr. Soong has led implementation projects to reduce unnecessary urinary catheter use, as well as unnecessary use of benzodiazepines and other sedative-hypnotics (BSH) in older adults at Mount Sinai. This project even inspired the Choosing Wisely Toolkit, Less Sedatives for Your Relatives with the intervention spread to other hospitals. Beyond these efforts, Mount Sinai has actively participated in the Using Blood Wisely and Using Labs Wisely programs. Choosing Wisely Canada caught up with Dr. Soong to discuss this achievement and Sinai Health’s future improvement goals. 

Choosing Wisely Canada: Tell us a bit about how your hospital got involved in Choosing Wisely.

Christine Soong: The principles of Choosing Wisely have always closely aligned with Sinai Health’s commitment to excellence in quality improvement. Many of our staff and clinicians have been early adopters of resource stewardship, participating in the creation and implementation of Choosing Wisely Canada recommendation lists. Since its inception in 2014, I have been involved in Choosing Wisely activities such as co-leading the development of two professional society Choosing Wisely Canada lists related to Hospital Medicine and Internal Medicine, as well as creating implementation toolkits. Choosing Wisely recommendations provide an evidence-based foundation for clinicians and staff to take on projects related to reducing unnecessary tests, treatments, and procedures.  Throughout my years of involvement with Choosing Wisely, I’ve seen how it can effectively engage clinicians in important quality improvement work.

CWC: What motivated your hospital to pursue the Choosing Wisely Canada Hospital Leadership Status?

CS: Mount Sinai was actively involved in Choosing Wisely Canada’s past Hospital Designation Program. With the introduction of the new designation program, we aimed to increase our involvement by participating in the quality improvement programs Using Labs Wisely and Using Blood Wisely as well as incorporating Choosing Wisely principles in our Quality Improvement Plan with executive leadership support. These initiatives help us improve our blood transfusion practices and reduce unnecessary lab testing. With active engagement and support from executive leadership, we were able to make Choosing Wisely part of Sinai Health’s ongoing organizational strategy.

CWC: What was it like to mentor another hospital? What learnings from that experience will you take forward?

CS: We worked with William Osler to support the implementation of Choosing Wisely recommendations on reducing repetitive routine blood tests and appropriate use of urinary catheters based on Choosing Wisely Canada’s Pause the Draws and Lose the Tube toolkits. William Osler Hospital is a leader in Choosing Wisely initiatives, and it was invaluable to share challenges, learnings, and find growth opportunities with them. It was great working with the William Osler clinicians and staff, who like those at Sinai Health, are committed to quality improvement.

CWC: What does the Leadership Status represent to your hospital?

CS: We are deeply proud of Mount Sinai teams for attaining this status and sustaining improvements in so many areas for the last few years. It is incredible to be among a handful of hospitals leading this work. Quality improvement efforts involve everyone — from executive leadership to clinicians and hospital staff — each playing a crucial role in improving the quality and safety of care. Above all, this achievement is an acknowledgement of the accomplishments of our entire organization.

CWC: In the future, how do you plan to continue Choosing Wisely efforts?

CS: We will continue to sustain our efforts with future plans of taking on new improvement areas. Part of this work involves disseminating and evaluating our results through quality improvement research, which will not only help us build on our success, but also provide valuable data for similar initiatives in other organizations.  We’re proud of this Leadership Status in recognition of our hospital-wide improvement efforts, and we look forward to further fostering a culture of ongoing improvement.