Transcript Choosing Wisely - National Hospice and Palliative Care Organization

National Hospice and Palliative Care
Organization
Helping Physicians Help Patients to
Choose Wisely
National Hospice and Palliative Care
Organization
Choosing Wisely® Goal
 …help physicians, patients and other
healthcare stakeholders think and talk about
appropriate medical care including overused
or misused tests and procedures that
provide little benefit, or even potential harm
National Hospice and Palliative Care
Organization
Choosing Wisely®
 Aims to promote conversations between
physicians and patients by helping patients
choose care that is:
 Supported by evidence
 Not duplicative of other tests or procedures already
received
 Free from harm
 Truly necessary
National Hospice and Palliative Care
Organization
Choosing Wisely®
 Created by the American Boards of Internal
Medicine Foundation
 Consumer Reports is creating
patient/caregiver information to supplement
the lists created by and for physicians
National Hospice and Palliative Care
Organization
American Academy of Hospice and
Palliative Medicine List
 Don’t recommend percutaneous feeding
tubes in patients with advanced dementia
 Don’t delay palliative care for a patient with
serious illness
 Don’t leave an ICD activated when patient
wants comfort care only
National Hospice and Palliative Care
Organization
American Academy of Hospice and
Palliative Medicine List
 Don’t recommend more than a single fraction of
palliative radiation for an uncomplicated painful
bone metastasis
 Don’t use topical lorazepam (Ativan),
diphenhydramine (Benadryl), haloperidol (Haldol)
(“ABH”) gel for nausea
National Hospice and Palliative Care
Organization
American Geriatrics Society
 Don’t recommend percutaneous feeding tubes
in patients with advanced dementia
 Don’t use antipsychotics as first choice to treat
behavioral and psychological symptoms of
dementia
 Avoid using medications to achieve hemoglobin
A1c <7.5% in most adults age 65 and older
National Hospice and Palliative Care
Organization
American Geriatrics Society
 Don’t use benzodiazepines or other
sedative-hypnotics in older adults as first
choice for insomnia, agitation or delirium
 Don’t use antimicrobials to treat bacteriuria
in older adults unless specific urinary tract
symptoms are present
National Hospice and Palliative Care
Organization
Hospice is Your Partner
 In facilitating advance care planning
discussions
 Whenever you need a palliative care
consultation for a patient
 Breaking bad news
 Goal setting
 Pain and symptom management
National Hospice and Palliative Care
Organization
Learn More
 www.choosingwisely.org
 www.caringinfo.org
 Artificial Nutrition and Hydration
 Asking Tough Questions
 NHPCO Position Statement on ICDs and Hospice
 INSERT YOUR WEB ADDRESS HERE