Two reviews detail top five Choosing Wisely recommendations for improving health care value
MONDAY, Aug. 19 (HealthDay News) -- Five recommendations for improving health care value have been identified for pediatric hospital medicine and hospital medicine, according to two reviews published online Aug. 19 in the Journal of Hospital Medicine.
As part of the Choosing Widely campaign to reduce overuse of tests and therapies in medical care, Ricardo A. Quinonez, M.D., from the Baylor College of Medicine in Houston, and colleagues developed a list of five recommendations for pediatric hospital medicine. These include not ordering a chest radiograph in children with asthma or bronchiolitis; not using systemic corticosteroids in children younger than 2 with lower respiratory chest infection; not using bronchodilators in children with bronchiolitis; not using acid suppression therapy as routine for infants with gastroesophageal reflux; and only using continuous pulse oximetry routinely in children with acute respiratory illness if they are on supplemental oxygen.
John Bulger, D.O., M.B.A., from the Geisinger Health System in Danville, Penn., and colleagues used a staged methodology to develop the adult Choosing Wisely list. The five recommendations include not placing or leaving urinary catheters in place for non-critically ill patients; not prescribing medications for stress ulcer prophylaxis for medical inpatients; avoiding transfusion of red blood cells for arbitrary hemoglobin or hematocrit thresholds; use of a protocol governing continuation when ordering continuous telemetry monitoring outside the intensive care unit; and not performing repetitive complete blood count and chemistry testing during clinical and lab stability.
"Choosing Wisely has created a language and a framework that will allow our field and others to tackle the crucial work of resource stewardship with new purpose, and we hope, unprecedented success," write the authors of an accompanying editorial.
Abstract - Quinonez (http://onlinelibrary.wiley.com/doi/10.1002/jhm.2064/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/jhm.2064/full )Abstract - Bulger (http://onlinelibrary.wiley.com/doi/10.1002/jhm.2063/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/jhm.2063/full )Editorial (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/jhm.2075/full )