Earlier this year, Osler became one of the first hospitals in Canada to be recognized by Choosing Wisely Canada at the Leadership Status level, the highest achievement awarded under the national program. 

To earn their Leadership Status, Osler has demonstrated the strongest commitment to leading change to reduce overuse through organizational leadership, implemented culture change, mentored a nearby hospital and ensured sustainability throughout its practices.

To showcase their efforts, Choosing Wisely Canada caught up with one of Osler’s physicians, Dr. Saranya Arnoldo, Clinical Biochemist at Brampton Civic Hospital.

Choosing Wisely Canada: Tell us about how your hospital got involved in Choosing Wisely, more specifically about reducing overuse/inefficient care?

Saranya Arnoldo: Our interest in Choosing Wisely started in 2016. At Osler, we established the Choosing Wisely Steering Committee under the Corporate Quality Council to meet our commitment to delivering safe, compassionate, high-quality care every time. On the Pharmacy side, we launched the Antimicrobial Stewardship Program that reduces the days of antibiotic therapy. On the pre-operative side, we introduced systems that provide individual, patient-focused care designed to avoid medically unnecessary operative assessments.

The Laboratory Medicine team’s main focus was on laboratory initiatives, which included identifying and limiting unnecessary testing for our patients. This approach led us to create a better patient experience, lower patient wait times, a decreased length of stay and a more standardized approach to diagnostic tests across our hospitals.

Since 2016, we successfully implemented all laboratory projects in collaboration with the Emergency Department (ED), Medicine Programs, and Critical Care, with endorsement from Osler’s Medical Advisory Committee.

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

SA: Despite the pandemic’s challenges, we remained resilient and dedicated to advancing patient safety and health quality. As a credit to all of our hardworking staff, Osler succeeded in becoming the first community hospital to achieve the highest Choosing Wisely Canada level 3 Hospital designation.

Achieving this designation, and seeing the positive impacts on patient care, fueled our motivation to continue to promote the standardization of care across sites and maintain our leadership in all Choosing Wisely activities. Earning this prestigious Leadership designation has been a wonderful acknowledgement of the efforts of our teams. The initiative was steered by Dr. Michael Miletin, our Executive Quality Medical Director, promoting a culture shift in how we think about delivering the most effective way of providing care at Osler.

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

SA: Through our close partnership with Headwaters Health, we passed on our experiences and aligned some of our practices. The key to our success was our continuous communication with a clinician from each area of practice.

We learned that a structured communication approach was important to building a successful mentorship. The first step of the approach was to review their current utilization processes and to align their medical directives with ours. Based on our findings we initiated discussions with leadership and the broader team to implement changes where needed.

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

SA: The Choosing Wisely Canada Leadership designation exemplifies Osler’s mission to provide patient-inspired health without boundaries. Achieving this designation was made possible by working together as a team. Through grit and teamwork, we created an inter-professional work environment throughout the organization.

At Osler, we continuously provide innovative health care, delivered with compassion. This designation solidifies our commitment to live this vision with our colleagues and patients.

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

SA: Through Osler’s participation in the national Choosing Wisely initiative, we will apply current clinical best practices to consistently provide high-quality, safe care to our patients.

This includes making the best use of diagnostic imaging and laboratory tests, and engaging patients in conversations about their care. Osler adopted Choosing Wisely’s “pause the draws” initiative to reduce unnecessary blood draws, and reduced bloodwork by 25% in the Department of Medicine. These actions create a better patient experience in the ED by reducing the number of commonly ordered laboratory tests.