Dr. Donna Goodridge
You recently published “Choosing wisely: The Canadian Thoracic Society’s list of six things that physicians and patients should question.” What are the key points for patients and physicians?
Because health care research is rapidly developing new diagnostic tests and treatments, it can be difficult for health care providers to keep up with the latest developments and provide their patients with evidence-based care. Choosing Wisely is an international campaign to help health care providers and patients engage in conversations about unnecessary tests and treatments as a strategy to improve the quality of care and reduce waste in health care. In conjunction with Choosing Wisely Canada, our national task force examined the recommendations of 25 professional societies’ to create a list of possible topics in the area of respiratory health that would be relevant in Canada. We conducted three rounds of ranking by members of the Canadian Thoracic society to narrow our initial list of 40 recommendations down to six. The criteria used to select and prioritize the recommendations included: risk/cost-benefit ratios, the research evidence base, how commonly the issue occurred, whether the change was in the span of control of individual physicians, whether the practice caused harm, the relevance across the country and whether changes in practice related to that recommendation could be measured. We arrived at six recommendations that were published in the Canadian Journal of Respiratory, Critical Care and Sleep Medicine in June, 2017.
How does Choosing Wisely help improve quality of care?
It is estimated that about 20-30% of patients in the U.S. receive care that may be potentially harmful. In Canada, a recent report suggested that about 30% of diagnostic tests, treatments and procedures are potentially unnecessary, resulting in more than one million occurrences of unnecessary care every year.
How can patients engage in self-management of chronic illnesses?
Self-management of chronic illness involves patients taking an active role in caring for themselves. We know that patient engagement in care can: be associated with fewer adverse events, result in fewer diagnostic tests, reduce the use of health services and result in shorter lengths of hospital stay. Patients and families who are engaged in care can provide essential information that will facilitate appropriate care planning, recognize mistakes in care delivery and are more likely to adhere to their treatment plans.
What research questions are you currently working on or looking forward to exploring?
Two projects that I am currently involved with are the evaluation of interdisciplinary bedside rounds during hospitalization and collaborative goal-setting between patients and providers. The first project involved bringing the team of health care providers to the patient’s bedside so that everyone can participate in the important discussions around the plan of care. The second project involves patients identifying their key health care priorities in a structured manner and sharing these with their physicians so that the most important healthcare goals can be addressed in a timely and effective manner
Dr. Donna Goodridge
Donna Goodridge, RN, Ph.D. is a Professor in the Division of Respirology, Critical Care, and Sleep Medicine and the Director of the Respiratory Research Centre at the University of Saskatchewan. She is currently the Co-Chair of the Canadian Thoracic Society (CTS) COPD Clinical Assembly and a member of the CTS Choosing Wisely Task Force. Dr. Goodridge is a co-Director of the Foundations undergraduate Respiratory Module at the University of Saskatchewan. Her primary research interests are health system improvement and re-design (including Lean and remote patient monitoring); and patient engagement in self-management of chronic illnesses and age-related conditions.
Picture credit: University of Saskatchewan