March 29, 2023
Two clinical teams have been named 2023 Choosing Wisely® Champions by AMDA – The Society for Post-Acute and Long-Term Care Medicine. The award honors individual clinicians and teams of clinicians who have gone above and beyond to make significant contributions to advance the ideals of the ABIM Foundation’s Choosing Wisely campaign by working to reduce unnecessary tests, treatments, and procedures in health care.
The first team, led by Katherine Coffey-Vega, MD, a geriatrician and director of transitions of care management at the Carilion Clinic in Virginia, applied Choosing Wisely practices in the critical emergency department at Carilion Roanoke Memorial Hospital. Specifically, she and Dr. Jeff Goode collaborated to create a program that addressed the AMDA Choosing Wisely recommendation, “Don’t recommend aggressive or hospital-level care for frail individuals without a clear understanding of the individual’s goals of care and the possible benefits and burdens.” They also applied other Choosing Wisely recommendations addressing inappropriate medication use in their initiative. Early results suggest that this program has promoted delirium prevention strategies, medication reconciliation, and the establishment of care goals at the start of hospital care.
“Receiving this award means a great deal. I am a common-sense practitioner, and I have always loved the Choosing Wisely® concept. These recommendations help us be good stewards with the resources we have and continually provide quality care,” said Dr. Coffey-Vega.
The second team, led by Zachary Palace, medical director of Hebrew Home at Riverdale in New York, began an initiative to eliminate the long-term use of sedative hypnotic medications for sleep induction in the nursing home population. The initiative was based on the AMDA Choosing Wisely recommendation, “Don’t routinely prescribe or continue sedative hypnotics for long-term treatment of sleep disorders in geriatric populations.” Key to the program was ongoing communications and education with clinical team members, including the consultant pharmacist, and residents’ families. During the first year, there was a 53% reduction in sedative hypnotic usage. To date, this rate is up to 64%.
“As a geriatrician and medical director, my focus has always been on high-quality medicine with a focus on maintaining the best possible quality of life and using proven measures to reduce adverse outcomes and avoid issues of polypharmacy,” said Dr. Palace. “The Choosing Wisely initiative helped give our project more credence, particularly when educating families and residents. This is not just a home-grown project but a national effort to improve geriatric care.”
Launched in 2012 by the ABIM Foundation, Choosing Wisely is widely recognized across the health-care system as a leading effort to reduce overuse in medicine. More than 80 specialty societies, including AMDA, have published over 600 recommendations regarding overused or unnecessary care.
For more information about Choosing Wisely and the Choosing Wisely Champions awards program, visit www.choosingwisely.org.
###
About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.
