There have been many initiatives to improve the utilization of health care resources in general, but none have gained the momentum of Choosing Wisely, which began in the United States in 2012. In Canada, there are approximately 50 professional societies providing hundreds of recommendations. In 2018, the Canadian Society for Medical Laboratory Science (CSMLS) agreed to become a campaign partner with Choosing Wisely Canada (CWC).
In 2018, the CSMLS and University of Alberta (UofA) Medical Laboratory Science Division came together and partnered on a project to facilitate the medical laboratory professional’s position in reducing unnecessary testing in the health care system.
The partnership involved the collaborative creation of this website, which contains three key sections.
First, a profession-specific list of recommendations generated through a multi-pronged engagement process. To help maximize the impact of these items, a broader understanding of current MLP attitudes, awareness and engagement related to CWC is needed. Research is required to fill this gap in knowledge.
Second, a compilation of current CWC recommendations related to the laboratory along with an educational tool to help practitioners understand how they can influence the use of the recommendations.
Third, web-based financial simulation calculator that will determine savings and waste reduction metrics of implementing CWC recommendations. The calculator provides medical professionals with evidence to help impact change within their workplaces through the adoption of recommendations.
It is through the deliverables of this partnership and the tools, resources and products produced that we hope to encourage national change in laboratory utilization. We welcome all medical professionals and members of other health professions to join us in this endeavour.
Please contact research@csmls.org with any comments, suggestions or ideas.
In late 2018, a call was placed for volunteers to serve on an expert panel to contribute to various aspects of this project. Many answered that call, but ultimately 17 panel members, 6 consultants and 2 emerging professionals representing a wide breadth of experience and geography were selected. Their primary purpose was to help generate a list of CWC recommendations specific to MLPs. This first involved exploring what this could even mean for a profession that is typically regarded as taking on a more technical and responsive role. Through many meetings and brainstorming sessions, an initial list of over 100 potential CWC items was created. Through highly detailed and complex prioritization, ranking and evidence-generating exercises, the expert panel worked to distill that list down to the 5 recommendations that will be published here and on the CWC website.
We are proud of what the Expert Panel has accomplished as Lab Wisely enthusiasts, and we express our deep gratitude for their dedication and time.
Building off the success of the 2018 panel, CSMLS formed a second committee of medical laboratory professional subject matter experts. They met in early 2023 to develop a strategy to create new recommendations. Subcommittees were formed to explore multiple sources of potential list items, including the list of reprioritized items from the first iteration to identify MLP recommendations in 2018-2019, laboratory-related items published by other societies in Choosing Wisely Canada and several other countries, and through leading discussions at their local sites. A long list of items was discussed at a meeting in June 2023, and forty-two were deemed potential candidates for further consideration. The committee then went through an asynchronous prioritization exercise to identify the most important recommendations with respect to frequency, potential for waste, potential for harm, and professional barriers to future action. The prioritization exercise identified the most important recommendations, which were subjected to analysis of the quality of published evidence supporting each recommendation. The draft recommendations were approved by the Board of Directors of the CSMLS in December 2023.
Once again, we are proud of what this Expert Panel accomplished as Lab Wisely enthusiasts, and we express our deep gratitude for their dedication and time.
This committee was established in late 2021 to ensure that the Lab Wisely database is properly controlled, monitored, and maintained across time. The committee meets quarterly to review changes and additions to Choosing Wisely Canada (CWC) recommendations and to categorize and tag the lab-relevant recommendations for inclusion in the database. CSMLS appreciates the diligence and thoughtfulness of the volunteers who come together and help curate the knowledge that is most impactful to the medical laboratory profession.
The aim of this project was to develop a new tool, a web-based financial simulation widget that determines savings and waste reduction metrics of implementing CWC recommendations. The widget provides medical professionals with evidence to support the adoption of recommendations and better equip them to influence change within their workplaces.
CSMLS gratefully acknowledges the funding to support this project provided by Choosing Wisely Canada. In addition, we acknowledge the dedication and enthusiasm of our partners who helped collect and validate the information it contains.
There were other individuals who reached out and inquired how they could support the project across time. We would like to thank these CSMLS members, medical laboratory science research practicum students and PhD supervisors for their enthusiasm and contributions as well.