Remarques d’ouverture de :

• Dre Guylène Thériault, Choisir avec soin
• Dre Kathleen Ross, Association médicale canadienne

Sustaining Change in Hospitals (EN)

Many hospitals embark on quality improvement projects to implement change and reduce overuse. However, sustaining these efforts long term can be challenging. This session will share practical guidance on how to effectively implement and sustain quality improvement initiatives to deliver high-quality care.

Dr. Christine Soong, Division Head of the Division of Hospital Medicine at Sinai Health and Hospital Designation Program Clinician Lead, Choosing Wisely Canada

Learning Objectives:

• Describe ways to implement Choosing Wisely in hospital settings
• Explain potential barriers and facilitators in driving and sustaining change in hospital settings
• Identify measurable quality metrics and indicators to assess the impact of Choosing Wisely implementation efforts

Taking a Bite Out of Antibiotic Prescribing: Encouraging Antimicrobial Stewardship in Dentistry (EN)

Dental antimicrobial stewardship (AMS) has an important role to play in global efforts to tackle antimicrobial resistance. This workshop offers participants an opportunity to explore the challenges and opportunities of AMS in dentistry, providing potential strategies and tools to reduce unnecessary antibiotic prescribing.

Dr. Karen Born, Program Director, Institute for Health Policy, Evaluation and Management, University of Toronto
Dr. Christiana Martine, Researcher, Faculty of Dentistry, University of Toronto
Susan Taylor, Director, Quality, Royal College of Dental Surgeons of Ontario

Learning Objectives:

• Describe potential challenges and opportunities in dental antimicrobial stewardship efforts
• Discuss the development of educational tools and resources that help support antimicrobial stewardship in dental practice
• Identify potential strategies for engaging dentists in antimicrobial stewardship efforts

Abstracts on Choosing Wisely and Climate Action (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature resource stewardship projects related to Choosing Wisely and climate action.

Reducing the Climate Impact of Rescue Inhalers for Asthma
Rosemarie Vincent, McGill University

Development of Canadian Critical Care Society Environmental Sustainability Choosing Wisely Canada Recommendations
Dr. Marko Balan

“Desflurane needs to Des-appear”: Banning a Harmful Anesthetic Gas Across NL
Dr. Krista Mahoney, Memorial University

Learning Objectives:

• Recognize the important role clinicians play in leading change in the climate crisis
• Describe practical examples of environmentally sustainable initiatives to reduce overuse in practice
• Discuss tools and resources to support clinicians in implementing environmentally sustainable practice

Abstracts on Choosing Wisely in Pediatrics (EN)

This session will provide practical insights and approaches to integrating Choosing Wisely and resource stewardship in settings caring for children.

Less is Best: Creating a Bronchiolitis Toolkit for Change
Dr. Katie Gardner, Choosing Wisely Canada Nova Scotia and IWK Health Centre

Supporting Parents to Choose Wisely: Randomized Trial and Qualitative Study
Sarah Elliott, University of Alberta

A two-step Pathway for Non-Invasive Urinary Tract Infection Screening
Dr. Nardin Kirolos and Dr. Andrea Rossos, University of Toronto

Learning Objectives:

• Describe practice changes to reduce the overuse of tests and treatments in pediatric populations
• Describe effective approaches to integrating Choosing Wisely implementation efforts in pediatric settings
• Identify tools and opportunities to support clinicians in pediatric resource stewardship efforts

N’utilisez pas de bandelettes urinaires chez les personnes âgées

Cette séance discutera des outils et des stratégies pour l’utilisation appropriée de l’analyse d’urine dans les établissements de soins de longue durée.

Objectifs d’apprentissage :

• Décrire les critères de Loeb et leur application pour déterminer la nécessité d’analyses et de cultures d’urine dans les établissements de soins de longue durée,
• Identifier les stratégies d’amélioration de la qualité pour encourager une utilisation appropriée de l’analyse d’urine dans les établissements de soins de longue durée
• Discuter des moyens potentiels d’identifier les obstacles et d’améliorer les analyses d’urine

Using Blood Wisely (EN)

This session will provide valuable insights into leading blood stewardship efforts to protect this vital but limited health care resource, drawing on the experiences and lessons learned from three years of the Using Blood Wisely program.

Dr. Yulia Lin, Transfusion Specialist, Sunnybrook Health Sciences Centre and Using Blood Wisely Clinician Lead, Choosing Wisely Canada
Marie-Hélène Robert, Héma-Québec

Learning Objectives:

• Describe efforts to improve transfusion practices in hospital settings
• Summarize findings and trends from three years of the Using Blood Wisely program on reducing inappropriate transfusion practices
• Discuss future opportunities to advance blood stewardship in hospital settings

Finding the Sweet Spot: Choosing Glycemic Control Wisely in Long-Term Care (EN)

Older adults with diabetes and frailty living in Canada’s long-term care homes are often treated counter to recommendations from evidence-based guidelines, increasing their risk for adverse outcomes. Clinicians face daily dilemmas regarding the roles of new monitoring technology and medications classes. This workshop will use clinical cases to explore these clinical uncertainties.

Dr. Andrea Moser, Family Physician Care of the Elderly, Associate Professor, University of Toronto
Dr. Iliana Lega, Scientist, Women’s College Research Institute and Staff Endocrinologist, Women’s College Hospital
Dr. Wade Thompson, Pharmacist and Assistant Professor, University of British Columbia
Dr. Lisa McCarthy, Clinician Scientist, Trillium Health Partners, University of Toronto

Learning Objectives:

• Highlight the evidence supporting new Canadian Society for Long-Term Care Medicine (CSLTCM) recommendations regarding avoiding sliding scale insulin and focusing on relaxed glycemic targets
• Discuss the role of new monitoring technologies and novel antihyperglycemic medication options for LTC residents
• Describe approaches for having conversations with residents and families regarding goals of diabetes care

Abstracts on Reducing Unnecessary Testing (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature implementation and measurement efforts on unnecessary testing in hospitals.

Use of Routine Bloodwork on General Internal Medicine Inpatients: A Retrospective Cohort Study
Dr. William Silverstein, Sunnybrook Health Sciences Centre

Reduction of Unnecessary Routine CBC Testing After Cesarean Deliverys
Dr. Yannay Khaikin, University of Toronto

Reducing Unnecessary Thyroid Function Testing Through Optimizing Test Ordering Protocols
Dr. Joel Scott, University of Saskatchewan

Sources of Variability and Unnecessary Blood Testing in the Intensive Care Unit
Dr. Thomas Bodley, University of Toronto

Learning Objectives:

• Describe efforts to reduce low-value tests in hospital settings
• Illustrate successful examples of implementation efforts in hospital settings
• Identify tools and resources that can support clinicians in reducing unnecessary testing and treatments in hospitals

Innovations dans Choisir avec soin (FR)

Les résumés présentent des initiatives Choisir avec soin et des approches innovantes de partout au pays. Cette session présentera des projets liés à la réduction de la surutilisation et à l’amélioration des pratiques.

Pour une pratique éclairée : une formation sur l’utilisation judicieuse de ressources en soins primaires
Dr Samuel Boudreault, médecin de famille (Joliette), directeur du programme de médecine familiale, Université Laval

Portrait de la polypharmacie et de l’usage de médicaments potentiellement inappropriés chez la personne âgée au Québec
Marie-Pierre Rousseau et Rodolphe Jantzen, INESSS

Campagne sur le traitement non-pharmacologique de l’insomnie
Dr Pierre Luc Thériault

Comment la pratique avancée en physiothérapie optimise le parcours clinique vers l’orthopédie et la neurochirurgie 
Marjorie Gingras, Association Québécoise de la Physiothérapie (AQP)

Objectifs d’apprentissage :

• Décrire des exemples pratiques d’initiatives visant à réduire la surutilisation dans la pratique
• Discutez des outils et des ressources pour aider les cliniciens à mettre en œuvre Choisir avec soin

Dépister avec soin : Intégrer la décision partagée (FR)

Cette séance discutera des pratiques appropriées en matière de dépistage et des stratégies de communication pour discuter des avantages et des risques du dépistage.

Dre Geneviève Bois, médecin de famille (Whapmagoostui), professeure adjointe, Université de Montréal

Objectifs d’apprentissage :

• Identifier les bonnes pratiques entourant le dépistage
• Discuter des zones d’incertitudes en ce qui concerne le dépistage
• Communiquer les bénéfices et risques en dépistage

Medication Appropriateness in Canada 

Medication prescribing is one of the most common activities in clinical practice. However, the issue of overuse and inappropriate prescribing poses significant challenges in health care. Expert speakers from hospitals, long-term care, and primary care settings will discuss the current landscape and future of prescribing practices in Canada.

• Dr. Barbara Farrell,  Senior Investigator with the Bruyère Research Institute
• Dr. John Hirdes, Professor, School of Public Health and Health Sciences, University of Waterloo
• Dr. Emily McDonald,  Associate Professor of Medicine, McGill University, and Scientific Director, Canadian Medication Appropriateness and Deprescribing Network

Learning Objectives:

• Identify common drivers and barriers in medication appropriateness across primary, long-term care, and hospital sectors
• Illustrate successful implementation examples to address common drivers of overuse
• Discuss potential strategies to advance medication appropriateness across sectors

Ditch the Dipsticks in Older Adults (EN) 

Dipsticks in older adults and long-term care residents are positive over 80% of the time. In clinical practice, these positive results are equated to the presence of urinary infection even in the absence of compatible presentation, prompting unnecessary urine cultures, antibiotics, or both, and leading to increased risks, including antibiotic resistance. This session will explore the barriers to change and share practical solutions to address this overuse problem across both long-term care and acute care sectors.

Dr. Jerome Leis, Using Antibiotics Wisely Clinician Lead, Choosing Wisely Canada

Learning Objectives: 

• Describe evidence supporting de-adoption of urinalysis and urine dipsticks for older adults (over the age of 65)
• Discuss importance of a unified approach across different health care sectors
• Identify strategies to successfully de-adopt these tests across both long-term care and acute care settings

Advancing Quality Improvement to Reduce Overuse, Advance Quality and Environmental Sustainability (EN) 

This workshop will share how sustainability, reducing overuse and advancing quality of care in health systems are intricately linked. It will identify sustainability co-benefits in the practices and projects that are already being implemented to reduce overuse and advance quality.

Dr. Karen Born, Program Director, Institute for Health Policy, Evaluation and Management, University of Toronto
Dr. Nicole Simms, Executive Lead and Training and Education Lead, CASCADES

Learning Objectives: 

• Situate environmental sustainability as a pre-requisite, goal, and outcome of high-quality care across all domains of quality
• Examine strategies to incorporate climate-relevant objectives and measures in quality improvement projects
• Review QI projects focused on reducing overuse that have focused both directly and indirectly on reducing the environmental impacts of care

Abstracts on Imaging and Testing Wisely (EN)

Abstracts feature Choosing Wisely initiatives and innovative approaches from across the country. This session will feature initiatives tackling unnecessary imaging and low-value testing.

Utility and Practices of Routine Post Cardiac Surgery Testing in Adult Patients
Dr. Marko Balan

Canadian Association of Radiologists Diagnostic Imaging Referral Guidelines
Dr. Candyce Hamel, Canadian Association of Radiologists

Developing an Intervention for Implementing Low Back Pain Choosing Wisely Recommendations
Véronique Lowry, Université de Montréal

Learning Objectives: 

• Describe efforts to reduce inappropriate imaging
• Illustrate successful examples of implementation in reducing unnecessary imaging
• Identify tools and resources that can support the reduction of unnecessary imaging tests

Choisir avec soin et action climatique (FR) 

Cette séance discutera de la réduction de la surutilisation et de la manière dont cela profite aux patients et à la planète.

Dre Maxine Dumas Pilon, Département de médecine de famille, Université McGill
Dre Rebecca Bourgault, Collège Québecois des Médecins de Famille (CQMF)

Objectifs d’apprentissage :

• Reconnaître le rôle de Choisir avec soin dans la durabilité environnementale
• Décrire des approches pratiques pour intégrer la durabilité environnementale dans différents contextes de pratique.

Au-delà de l’AMM, comment changer la trajectoire de fin de vie des patients atteints de troubles neuro-cognitifs pour leur permettre de mourir dans la dignité (FR) 

Dre Géraldine Lachance-Fortin

Objectifs d’apprentissage :

• Connaître l’évolution naturelle des troubles neuro-cognitifs
• Explorer les données probantes en matière de prévention des troubles neuro-cognitifs
• Questionner l’éthique des soins curatifs à tout prix, sur le plan individuel, systémique et social
• Repérer des opportunités de discuter des objectifs de soins et de mourir de causes naturelles tout au long de la trajectoire des patients atteints de de troubles neuro-cognitifs et dans différents contextes cliniques (suivi de patients, urgence, hospitalisation et soins de longue durée)