Choosing WiselyŽ: Advancing Health through Nursing

The U.S. health care system is the most costly in the world, accounting for 17% of the gross domestic product with estimates that percentage will grow to nearly 20% by 2020. At the same time, countries with health systems that out-perform the U.S. are also under pressure to derive greater value for the resources devoted to their health care systems.  Inappropriate and overuse of procedures and testing in the U.S. healthcare system accounts for billions of dollars in inefficiencies, compromises quality of care, and puts patients at risk for harm. The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which are called the “Triple Aim”. These dimensions include:  improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

The innovative program entitled Choosing Wisely ® focuses on assisting in achieving the Triple Aim through patient empowerment.  An initiative of the American Board of Internal Medicine (ABIM) Foundation, Choosing Wisely ® is working to spark conversations between providers and patients to ensure the right care is delivered at the right time. Participating organizations have created lists of “Things Providers and Patients Should Question” which include evidence-based recommendations that should be discussed to help make wise decisions about the most appropriate care based on a patients’ individual situation. Delivery of this invaluable message to healthcare consumers should include nurses, the most trusted professionals, who outnumber physicians more than three to one. To achieve this, nursing societies have engaged to bring the Choosing Wisely ® program to nursing specialties across the state of Texas, impacting patient-centered care and engagement at the front lines of care.