Choosing Wisely Saskatchewan

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What is Choosing Wisely?

Choosing Wisely Saskatchewan is the provincial voice for reducing unnecessary tests and treatments in health care with an aim to improving patient safety and appropriateness of care for everyone in the province.

Choosing Wisely Saskatchewan is the provincial branch of Choosing Wisely Canada. The national office opened in 2014 and is located in Toronto. Choosing Wisely Canada partners with professional societies representing various clinical specialties to determine and share recommendations that focus on identifying tests and treatments commonly used that are not supported by evidence and could expose patients to unnecessary care and possible harm. The Choosing Wisely Canada Recommendations are shared out to each province to improve clinical practice, reduce potential for harm and improve appropriateness of care.

Why is Choosing Wisely important in Saskatchewan?

In 2017, Choosing Wisely Canada and the Canadian Institute for Health Information released a report titled “Unnecessary Care in Canada” that showed results of a study which focused on tests, treatments and procedures that don’t add value to a patient’s care journey or are considered unnecessary. Unnecessary means the use of health resources and procedures that are not supported by evidence, or that may be duplicate of other tests previously done. This can be care that could lead to harm and/or doesn’t improve outcomes for patients. It was found that up to 30% of tests, treatments and procedures in health care are unnecessary.

In the report, Saskatchewan was shown to have an inappropriate rate of prescribing low dose quetiapine for children and youth (ages 5 to 24) as a treatment for insomnia. There was also information that showed 21.8% of pre-operative tests for low risk procedures (ophthalmology procedures such as cataract surgery and endoscopy such as an upper gastrointestinal tract scope or colonoscopy) were unnecessary. A second report will be released in 2022.

Links of interest

• The Opioid death crisis in Canada: crucial lessons for public health
• Opioid and Stimulant Related Harms in Canada
• Four questions to ask your health care provider
• Choosing Wisely Canada Resources

In addition to the main focus of reducing the potential for harm and improving appropriateness of care, Choosing Wisely Saskatchewan advocates for resource stewardship. Since the health system is operating with publicly funded resources, it’s important to ensure we are practicing good stewardship and using health care resources appropriately.

Who is involved in Choosing Wisely in Saskatchewan?

Clinicians and staff within the Saskatchewan Health Authority are working in partnership with patient partners, primary care family physicians, the Saskatchewan Medical Association, the Ministry of Health and the Health Quality Council to help move the Choosing Wisely initiative forward in the province. There is a Choosing Wisely Saskatchewan Provincial Partners Group that functions as an advisory committee to build strategic plans that align with provincial priorities and help move the work forward.

A guiding principle of Choosing Wisely is that implementation of the recommendations to improve clinical practice is physician led. There are many physician champions across Saskatchewan leading this work and making changes to reduce the amount of unnecessary tests, treatments and procedures.