The Inaugural Choosing Wisely List for Pediatric Emergency Medicine: Strategies for Local Implementation

Sunday, April 30, 2023

2:00 PM – 3:30 PM ET

Location: Convention Center: 158 AB

CE: Live CME: 1.50

Leader(s)

Paul Mullan, MD, MPH (he/him/his)

Director of Quality Improvement and Research, Attending Physician, Emergency Medicine
Pediatrics
Children's Hospital of The King's Daughters, Division of Emergency Medicine
EVMS
Norfolk, Virginia, United States

Co-Leader(s)

Shabnam Jain, MD, MPH

Professor of Pediatrics and Emergency Medicine
Emory University School of Medicine
Atlanta, Georgia, United States
KL

Kelly Levasseur, DO, MHA (she/her/hers)

Medical Director
Children's Hospital of Michigan
Detroit, Michigan, United States
Michele Nypaver, MD (she/her/hers)

Co-Director
University of Michigan-Michigan Medicine
Northville, Michigan, United States
James Chamberlain, MD (he/him/his)

Director of Data Analytics, Division of Emergency Medicine
Children's National Health System
Washington, District of Columbia, United States
Olivia Ostrow, MD (she/her/hers)

Director of Quality, Emergency Medicine
The Hospital for Sick Children
Toronto, Ontario, Canada
Jennifer Thull-Freedman, MD, MSc

Clinical Associate Professor
University of Calgary
Calgary, Alberta, Canada
Lalit Bajaj, MD, MPH (he/him/his)

Professor
University of Colorado
Denver, Colorado, United States
Lori Rutman, MD, MPH (she/her/hers)

Associate Professor, Pediatrics and Emergency Medicine
Pediatrics, Emergency Medicine
Seattle, Washington, United States

Disclosure(s):

Paul C. Mullan, MD, MPH: No financial relationships to disclose

Shabnam Jain, MD, MPH: No financial relationships to disclose

Kelly Levasseur, DO, MHA: No financial relationships to disclose

Michele Nypaver, MD: Alligator Holdings: Advisory Committee (Ongoing), Advisory Committee (Ongoing), Ownership Interest including individual stocks, stock options, excluding diversified mutual funds (Ongoing), Ownership Interest including individual stocks, stock options, excluding diversified mutual funds (Ongoing)

James Chamberlain, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Olivia Ostrow, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Jennifer Thull-Freedman, MD, MSc: No financial relationships to disclose

Lalit Bajaj, MD, MPH: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Lori E. Rutman, MD, MPH: No financial relationships to disclose

Workshop

Description: In 2021, The American Academy of Pediatrics (AAP) assembled a task force to create the first Pediatric Emergency Medicine (PEM) Choosing Wisely (CW) list of recommendations, the first AAP list published by both American and Canadian CW organizations:

1. Do not obtain radiographs in children with bronchiolitis, croup, asthma, or first-time wheezing.
2. Do not obtain screening laboratory tests in the medical clearance process of pediatric patients who require inpatient psychiatric admission unless clinically indicated.
3. Do not order laboratory testing or a CT scan of the head for a pediatric patient with an unprovoked, generalized seizure or a simple febrile seizure who has returned to baseline mental status.
4. Do not obtain abdominal radiographs for suspected constipation.
5. Do not obtain comprehensive viral panel testing for patients who have suspected respiratory viral illnesses.
The interactive, small-group based workshop will have participants drafting QI tools to strategize how to implement the CW recommendations. A faculty-facilitated small group will be created for each CW recommendation. Participants will choose their small group.

Phase 1: Create a Cause and Effect Diagram in small groups to explore causes of over-testing. Small groups will then share their ideas with the full group for feedback and further input.

Phase 2: Create an aim and Key Driver Diagram to address one of the recommendations.

Phase 3: Reflect and identify one CW change they would like to make in their own practice.

Instructions on how to stay informed and engaged with the Choosing Wisely recommendations will be shared.

Learning Objectives:

Discuss the process for development and supporting evidence for the Choosing Wisely list of recommendations.
Identify barriers and strategies to the implementation of these recommendations by drafting a cause and effect diagram, aim statement, and a key driver diagram.
Recognize and define opportunities to implement PEM Choosing Wisely strategies in one’s own practice.