Quality & Regulatory Affairs  |   January 2014
‘Choosing Wisely’ in Anesthesiology: Top-5 List – Addressing the Gap Between Evidence and Practice
Article Information
Cardiovascular Anesthesia / Critical Care / Patient Safety / Quality Improvement / Quality & Regulatory Affairs
Quality & Regulatory Affairs   |   January 2014
‘Choosing Wisely’ in Anesthesiology: Top-5 List – Addressing the Gap Between Evidence and Practice
ASA Monitor 01 2014, Vol.78, 44-45.
ASA Monitor 01 2014, Vol.78, 44-45.
The “Choosing Wisely” campaign is an ongoing initiative by the American Board of Internal Medicine (ABIM) to help physicians become better stewards of finite health resources by encouraging conversations between physicians and their patients to ensure the right care is delivered at the right time.1  Interestingly, patients believe that the world of medicine should be a place where evidence-based findings roll out into practice with ease and finesse. The reality, however, remains that despite the breadth of evidence and knowledge necessitating the practice of validated evidence-based guidelines, the translation of evidence to clinical practice still remains patchy at best. With the current economic climate advocating for improving quality of care, patient satisfaction and outcomes measures while decreasing unnecessary cost, the adherence to evidence-based guidelines that improve these measures will become important for the sustenance of health care facilities in the near future. In 2009, the cost of unnecessary health spending was estimated at $765 billion, a quarter of which ($210 billion) was spent on the overuse of services, including services that are provided more frequently than necessary or services that are at higher cost, but no more beneficial than lower-cost alternatives.2  The use of unnecessary diagnostic tests and treatments is hardly a novel issue. Compared to 10 years ago, physicians today are equally likely to perform a complete blood count, electrocardiography and chest radiography as part of routine health maintenance examinations even when these tests offer no additional health information or benefits and expose these patients to harm.3 
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