CWTE: How to speak with families about NOT doing tests

"More is not always better when it comes to healthcare" is the mantra of the Choosing Wisely Australia campaign, which seeks to reduce unnecessary medical interventions. In this episode, Dr Joanna Lawrence, medical lead of the Choosing Wisely campaign at RCH, talks with A/Prof Ed Oakley about low value care. They discuss clinician reasons for performing low value tests and the potential harms. Ed discusses examples of low value care in the setting of bronchiolitis and pneumonia and how to approach discussing this issue with families. They reflect on the recommendation to treat on clinical grounds, trust your clinical judgement and reflect on the conscious decision to not perform tests.

Resources:

Top 5 'not to do practices' (low value care) as nominated by the RACP, Paediatric and Child Health division Royal Australasian College of Physicians PaCHd

Lawrence J, Andrew L, Bracken J, Voskoboynik A, Oakley E, South M, Middleton K, Scanlan B, Marshall T, Hiscock H. Bronchiolitis at a specialist paediatric centre: The electronic medical record helps to evaluate low value care. Journal of Paediatrics and Child Health/ Early View. Published online 25 August 2019 https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.14602

PODCAST DISCLAIMER:

This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics.

The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however t​he information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation.

This podcast should not be reproduced without the written permission of The Education Hub (education.hub@rch.org.au​).