quarta-feira, 22 de abril de 2015

Choosing Wisely International

Será com muita satisfação que participarei, junto com meu amigo Luis Claudio, do Blog Medicina Baseada em Evidências, de evento fechado da Choosing Wisely International:

2nd International Roundtable on Choosing Wisely, taking place in London, UK, on Thursday, May 28 and Friday, May 29, 2015.

Luis representará a Sociedade Brasileira de Cardiologia, enquanto representarei a Sociedade Brasileira de Medicina de Família e Comunidade, a quem agradeço fortemente pela oportunidade e confiança. SBC e SBMFC serão pioneiras ao inserir o Brasil na Choosing Wisely International (bastidores podem ser conhecidos aqui). Já estamos em tratativas com outras especialidades.

Os propósitos principais do evento, que reunirá lideranças de 16 países, são:

1. Compartilhar experiências sobre iniciativas “choosing wisely” nos diversos países;

2. Compartilhar estratégias de sucesso e desafios para implantação da Choosing Wisely, através dos cases norte-americano e canadense;

3. Discutir formas de melhor avaliar efeitos da campanha e, se possível, padronizar isto entre os países envolvidos.

Representantes da Organisation for Economic Co-operation and Development (OECD) and The Commonwealth Fund estão também envolvidos na iniciativa.

Abaixo a programação preliminar do evento:
2nd International Roundtable on Choosing Wisely
Royal College of Anaesthetists, Second Floor Gallery
35 Red Lion Square, London
9:00 – 9:15am
Welcome and Framing of the Meeting
Wendy Levinson
9:15 – 10:00am
Participants Identify Major Challenge
Description: Each person will introduce themselves and one representative from each country will name the main challenge they would like help with.
10:00 – 10:30am
Underlying Principles of Choosing Wisely and Application to Recommendations Development and Implementation
Description: Identify cultural shifts in society and business that are in play with Choosing Wisely including Self-Determination Theory and Complexity Theory.
Daniel Wolfson
10:30 – 10:50am
10:50 – 11:20am
Challenges and Successes in Implementation in Canada and US
Description: Using a structured format, identify strategies that have been employed and the challenges.
Wendy Levinson
Tai Huynh
11:20am – noon
Part 1 of Open Space
Description: Small groups will have the opportunity to work on topics of specific interest. The question “what do you want help on during this meeting” might form the basis of topics.
Daniel Wolfson
Noon – 12:45pm
12:45 – 2:00pm
Part 2 of Open Space
Description: Each group develops strategies and immediate actions steps. Each group reports out.
Daniel Wolfson
2:00 – 2:30pm
The Top Ten List
Description: We will revisit the list of top ten tests/treatments/procedures from last year and revise based on previous and current work. This list will form the basis for a later discussion with OECD.
Wendy Levinson
2:30 – 2:45pm
2:45 – 3:30pm
Framing Evaluation and Measurement
Description: Review of key evaluation efforts to date and challenges and barriers in evaluation.
Sacha Bhatia
3:30 – 4:30pm
OECD and Measurement of Overuse
Description: Explore cross-country comparisons of a limited set of recommendations.
Niek Klazinga
4:30 – 7:00pm
Social Dinner
Royal College of Anaesthetists, Council Chamber
35 Red Lion Square, London
Royal College of Anaesthetists, Second Floor Gallery
35 Red Lion Square, London
9:00 – 9:30
Summary of Prior Day’s Discussion
9:30 – 10:30am
Evaluation and Measurement – What is Next?
Description: What’s currently happening in other countries? Is there agreement on a framework to measure Choosing Wisely impact? How do we want to collaborate?
Small groups
10:30 – 10:45am
10:45 – 11:30am
Evaluation and MeasurementContinued
Large group
11:30am – 12:30pm
Patient/Public Engagement
Description: Discussion of strategies for patient/public engagement. What’s working and what are challenges?
12:30 – 1:30pm
1:30 – 3:00pm
Working Together Between Annual Meetings
Description: Discuss how this group wants to work together (i.e., small groups); how to organize the work and how we support each other.
Sam Shortt
3:00 – 4:00pm
Conclusion and Final Thoughts
Description: Identification of group goals and who will lead components.
Wendy Levinson

Suggested Readings
  1. Academy of Royal Colleges. Protecting resources, promoting value: a doctor’s guide to cutting waste in clinical care. 2014 Nov.
  2. Coronini-Cronberg S, Bixby H, Laverty AA, Wachter RM, Millett C. English National Health Service's Savings Plan May Have Helped Reduce The Use Of Three 'Low-Value' Procedures. Health Aff (Millwood). 2015 Mar 1;34(3):381-9.
  3. Gliwa C, Pearson SD. Evidentiary rationales for the Choosing Wisely Top 5 lists. JAMA. 2014 Apr 9;311(14):1443-4.
  4. Gupta S, Detsky AS. Development of Choosing Wisely Recommendations for an Inpatient Internal Medicine Service. JAMA Intern Med. 2015 Feb 23.
  5. Kerr EA, Chen J, Sussman JB, Klamerus ML, Nallamothu BK. Stress Testing Before Low-Risk Surgery: So Many Recommendations, So Little Overuse. JAMA Intern Med. 2015 Feb 9.
  6. Levinson W, Kallewaard M, Bhatia RS, Wolfson D, Shortt S, Kerr EA; Choosing Wisely International Working Group. 'Choosing Wisely': a growing international campaign. BMJ Qual Saf. 2015 Feb;24(2):167-74.
  7. Mason DJ. Choosing wisely: changing clinicians, patients, or policies? JAMA. 2015 Feb 17;313(7):657-8.
  8. Selby K, Gaspoz JM, Rodondi N, Neuner-Jehle S, Perrier A, Zeller A, Cornuz J. Creating a List of Low-Value Health Care Activities in Swiss Primary Care. JAMA Intern Med. 2015 Feb 23.
  9. Strech D, Follmann M, Klemperer D, Lelgemann M, Ollenschläger G, Raspe H, Nothacker M. When Choosing Wisely meets clinical practice guidelines. Z Evid Fortbild Qual Gesundhwes. 2014;108(10):601-3.

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