8.3 Case studies
Case 1: Choosing Wisely Australia
Choosing Wisely Australia, initiated by NPS MedicineWise in 2015 and backed by health professional bodies, fosters national discussion on avoiding unnecessary medical tests, treatments and procedures. It promotes healthcare that is evidence-based, non-redundant, safe and necessary, challenging the belief that more care is always better (O’Callaghan et al., 2015). The campaign encourages the use of theoretical models and frameworks to evaluate and address low-value care. For example, TDF is noted for its relevance in interventions that target professional practice and organisational behaviour change.
Choosing Wisely promotes improved dialogue between clinicians and consumers regarding necessary care, driven by six core principles focused on evidence-based, transparent and -improved practices. Recommendations developed by healthcare professionals provide a foundation for reducing unnecessary healthcare practices.
The campaign’s success highlights the power of provider and patient education in reducing low-value care. A key factor was the use of clear, evidence-based recommendations developed by professional societies, making it easier for providers to discuss and justify care decisions with patients. However, impact varied across different practices and regions, indicating the need for local implementation strategies and the importance of measuring and reporting outcomes.
Case 2: Royal Children’s Hospital
The Royal Children’s Hospital Melbourne is involved in reducing its conception of low-value care, focusing on unnecessary practices that provide little benefit, may cause harm or are costly. The Health Services Research Unit supports initiatives like the EVOLVE project by the Royal Australasian College of Physicians, which identifies low-value treatments in child health. It focuses on creating lists of treatments that should not be routinely performed, based on evidence and expert consensus, and uses a variety of behaviour change models and frameworks to create sustainable change and reduce low-value care. The goal is to improve patient care by eliminating unnecessary and potentially harmful interventions, promoting more sustainable healthcare practices. This is part of broader efforts to ensure healthcare is sustainable by focusing on effective, necessary treatments.
