Choosing Wisely Australia

Choosing Wisely Australia
Name	Choosing Wisely Australia
Formation	2015
Type	Non-profit initiative
Headquarters	Australia
Region served	Australia

Choosing Wisely Australia is an Australian health initiative that promotes conversations between clinicians and patients about unnecessary medical tests, treatments and procedures. It adapts an international movement to the Australian clinical and policy environment, aligning with peak bodies, professional colleges and consumer groups to reduce low-value care. The initiative interacts with health services, regulatory agencies and academic institutions to translate clinical recommendations into practice.

Overview

Choosing Wisely Australia functions as a coordinating body linking professional colleges such as the Royal Australasian College of Physicians, Royal Australasian College of Surgeons, Royal Australian and New Zealand College of Obstetricians and Gynaecologists and organizations including Australian Medical Association, Consumers Health Forum of Australia, Royal Australian College of General Practitioners and specialist societies. It produces lists of "do not do" recommendations, engaging stakeholders like the Australian Commission on Safety and Quality in Health Care, state health departments such as New South Wales Ministry of Health and institutions including Monash University, University of Melbourne and University of Sydney. The program interacts with international partners such as Choosing Wisely (United States), Choosing Wisely Canada and the World Health Organization to harmonize approaches to reducing low-value interventions.

History and Development

The initiative was launched in the mid-2010s amid global efforts following campaigns led by organizations like the American Board of Internal Medicine Foundation and movements associated with the Institute of Medicine (US). Early development involved collaboration with Australian professional colleges including the College of Intensive Care Medicine and the Australasian College for Emergency Medicine, and healthcare agencies such as the Australian Institute of Health and Welfare. Policy discussions referenced reports from bodies such as the Productivity Commission (Australia) and inquiries like commissions influenced by the Royal Commission into Aged Care Quality and Safety. Academic analyses from researchers affiliated with The George Institute for Global Health and institutes such as the Grattan Institute informed methods for prioritising recommendations.

Campaigns and Recommendations

Campaign outputs include specialty-specific lists produced by entities such as the Royal Australasian College of Physicians, Royal Australasian College of Surgeons, Australasian College of Dermatologists and the Royal Australian and New Zealand College of Psychiatrists. Recommendations target practices in settings from primary care represented by the Royal Australian College of General Practitioners to tertiary hospitals like St Vincent's Hospital, Sydney and Royal Brisbane and Women's Hospital. The initiative has produced materials for conditions and episodes such as antibiotic prescribing influenced by Therapeutic Guidelines (Australia), imaging stewardship engaging stakeholders like Australasian College for Emergency Medicine, and end-of-life care drawing on expertise from palliative services linked to Palliative Care Australia. Campaigns have been disseminated via partnerships with consumer organizations such as the Consumers Health Forum of Australia and professional regulators including the Medical Board of Australia.

Implementation and Impact

Implementation efforts have involved health services in jurisdictions such as Victoria (Australia), New South Wales and Queensland and collaborations with hospitals like Royal Prince Alfred Hospital and networks including Local Health Districts. Evaluation studies by academics from University of Sydney, Monash University and Deakin University have examined changes in test ordering, imaging rates and antibiotic use, with results compared to international evidence from Choosing Wisely (United States) and NHS England programmes. Policy levers explored include integration with quality frameworks from the Australian Commission on Safety and Quality in Health Care, incentives considered by the Department of Health and Aged Care (Australia), and educational interventions promoted by universities such as University of Queensland. Impact assessments have referenced health economics work from researchers associated with the Australian National University.

Criticism and Controversies

Critiques have arisen from stakeholders including specialty societies like the Royal Australasian College of Surgeons on matters of clinical nuance, and from commentators in media outlets such as analyses that referenced cases in public hospitals including Royal Melbourne Hospital. Concerns noted by academics from institutions like University of Melbourne and policy think tanks such as the Grattan Institute include measurement challenges, unintended reductions in appropriate care, and the need for robust evaluation comparable to studies in the United States Department of Health and Human Services context. Debates have involved regulatory bodies like the Therapeutic Goods Administration (Australia) when recommendations intersect with medical devices and the Australian Health Practitioner Regulation Agency where professional standards and medico-legal implications are implicated.

Governance and Partnerships

Governance involves collaboration among professional colleges (for example, Royal Australasian College of Physicians and Royal Australian College of General Practitioners), consumer groups such as the Consumers Health Forum of Australia, and health agencies including the Australian Commission on Safety and Quality in Health Care and state health departments like the New South Wales Ministry of Health. Partnerships extend to research institutions including Monash University, University of Sydney and The George Institute for Global Health, and to international networks such as Choosing Wisely Canada and Choosing Wisely (United States). Funding and oversight intersect with national bodies such as the Department of Health and Aged Care (Australia), philanthropy associated with foundations like the Paul Ramsay Foundation, and collaborative projects involving hospital systems including Calvary Health Care.

Category:Medical and health organisations based in Australia