This is a rapidly evolving situation that requires reevaluation daily. We recommend following the United States Centers for Disease Control and Prevention (CDC) for the most up-to-date information on the virus.
Read Dr. Baron and Daniel Wolfson’s letter to the Choosing Wisely Community.
Choosing Wisely Community Update
Dear Choosing Wisely community,
We know that the COVID 19 pandemic is the overriding concern for all of us in the health care system at this time. We greatly admire the work you are doing to address this crisis and provide urgently needed care.
In light of our current situation, we at Choosing Wisely have decided to scale back some of our activities for now, such as our monthly webinar series and this newsletter. We did want to take this opportunity, however, to recommend a few resources that might be helpful at this time:
- This podcast from the New England Journal of Medicine features a discussion with Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, about how to talk with patients about COVID-19.
- This newsletter article details how the University of Pittsburgh Medical Center promoted better blood management practices to avoid unnecessary transfusions – an issue of particular importance given widespread concerns about blood shortages in our current environment.
- This case study describes how Virginia Mason Medical Center in Seattle reduced the use of antibiotics for viral respiratory infections, including by offering nurse phone care instead of office visits for patients. Perhaps some of their insights can be used in helping your staff triage COVID-19 concerns from patients.
- For another approach to antibiotics, you can read about the “Wellness Bags” that Mayo Regional Hospital in Maine provides to patients instead of antibiotics. We’ve heard from partners who use a similar approach that they have added CDC patient tips for COVID-19 to these types of packets for patients coming in with concerns about the virus.
- Kognito has created modules to help patients and clinicians have better conversations about whether antibiotics are necessary.
We also want to let you know that we will continue to put resources on our Workplace site. If you’re not already a part of Workplace, you can join by filling out this form.
We look forward to sharing new updates from the field with you in the future.
Please stay safe! You are doing critically important work, and your patients and communities need you.
Richard Baron, MD
President and CEO
ABIM & ABIM Foundation
Daniel Wolfson, MHSA
Executive Vice President/COO
Partner Society Updates
During this time of great stress, Choosing Wisely is providing information from our partner societies about appropriate tests and treatments that are relevant to addressing the impact of the COVID-19 outbreak on the health care system:
- American College of Physicians
- American Society of Hematology & American Association of Blood Banks
- American Society for Health-System Pharmacists
- Infectious Disease Society of America
- Society of Hospital Medicine
American College of Physicians
Our Choosing Wisely partner, The American College of Physicians, is committed to doing everything possible to prevent and slow the spread of the virus to ensure that our patients get the care they need.
ACP has gathered updated resources, including an easily accessed physicians guide to assist internists seeking to prepare and manage their response to COVDID-19.
American Society of Hematology & American Association of Blood Banks
There has already been an impact on the blood supply as blood donations have dipped due to the cancellation of blood drives and people remaining home to avoid crowded areas. It is therefore important for hospital systems to take special care to follow Choosing Wisely recommendations from the American Society of Hematology (ASH) and the American Association of Blood Banks (AABB) which discourage inappropriate transfusion of blood products (e.g., transfusing more than medically necessary or transfusing when other treatment options, including observation, are available). Though Choosing Wisely recommendations are intended to guide decision making under normal working conditions, by closely adhering to these recommendations clinicians can help ensure there are sufficient stores of blood available for those patients that truly need them during the COVID-19 crisis.
American Society for Health-System Pharmacists
The American Society for Health-System Pharmacists (ASHP), a Choosing Wisely partner, has made resources available that may be helpful as you address COVID-19. ASHP maintains a drug information resource called AHFS. The ASHP team evaluated the evidence related to proposed treatments for people with COVID-19, and assessed the evidence around supportive treatments and selected chronic medications that may be used in this population. ASHP will continue to update this table as new evidence becomes available.
ASHP is also providing free access to its AHFS Clinical Drug Information app, which includes access to drug shortages information. Access information is provided below:
AHFS Drug Information® – Open Access for 60 Days Effective March 16, 2020
Infectious Disease Society of America
The Infectious Disease Society of America, a Choosing Wisely partner, has gathered tools and resources to help members make informed decisions related to COVID-19.
Resources include developments, guidelines, protocols, policies, and tools for practitioners provided by the U.S. Centers for Disease Control and Prevention, the Food and Drug Administration, the Centers for Medicare & Medicaid Services and the World Health Organization, as well as COVID-19 reports in IDSA journals, and the IDSA/HIVMA Science Speaks blog.
Society of Hospital Medicine
Many hospitalists provide critical care services, often without adequate support or training. Our Choosing Wisely Partner, the Society of Hospital Medicine, is actively monitoring the evolving outbreak of COVID-19 and is dedicated to supporting hospitalists with a library of COVID-19 blogs, articles, publications, videos, and webinars from hospitalists and thought leaders in the space.