Healthcare

Healthcare Professionals

Choosing Wisely Recommendation for Healthcare Professionals

Do not recommend Glycated Hemoglobin (HbA1c) routine frequent testing within three months of the period, especially in adults with stable type 2 diabetes.

Clinical Chemistry

Do not order repeated CBC and chemistry testing in the inpatient setting.

Clinical Chemistry

Do Not Routinely Test for Vitamin D.

Clinical Chemistry

Do not Routinely Order Thyroid Stimulating Hormone (TSH) Screening for low-risk patients.

Clinical Chemistry

Avoid Standing Repeated (CBC) on Inpatients Who Are Clinically-Laboratory Stable.

Clinical Chemistry

Avoid Ordering Daily (CBC) in Clinically Stable Patient.

Clinical Chemistry

Don’t Order Amylase Level in Diagnosing and Monitoring Acute Pancreatitis

Clinical Chemistry

Don’t Order Barbiturate Testing as Workplace Drug Tests

Clinical Chemistry

Don’t Order Erythrocyte Sedimentation Rate

Clinical Chemistry

Don’t Order Routine Screening for Zinc Deficiency in Asymptomatic Individuals

Clinical Chemistry

Do not continue dual antiplatelet therapy for all patients with acute coronary syndrome beyond 12 months

Clinical Pharmacy

Do not continue stress ulcer prophylaxis medications for ICU patients if the Patient is no longer at high risk for GI bleeding complications

Clinical Pharmacy

Self-monitoring of blood glucose

Clinical Pharmacy

In patients with CKD G3a-G5D and hyperphosphatemia

Clinical Pharmacy

In patients treated with statins, routine measurements of creatine kinase and transaminases are not helpful

Clinical Pharmacy

Do not routinely prescribe lipid-lowering medications in individuals with a limited life expectancy.

Clinical Pharmacy

Do not deeply sedate mechanically ventilated patients without a specific indication for deep sedation. Daily assessment and attempts to lighten.

Clinical Pharmacy

Do not give prophylactic antibiotics to patients with non-valvular cardiac or other indwelling devices undergoing dental procedures.

Clinical Pharmacy

Do not routinely prescribe antibiotics for patients with upper respiratory tract infections.

Clinical Pharmacy

Do not prescribe biologics for rheumatoid arthritis before a trial of methotrexate (or other conventional non-biologic DMARDs).

Clinical Pharmacy

Use of Indwelling Urinary Catheters in the ED

Emergency Medicine (EM)

Use of CK-MB in patients with chest pain when you have troponin

Emergency Medicine (EM)

Intravenous vs Oral Fluid Replacement for Pediatric Patients

Emergency Medicine (EM)

CT head in low-risk syncope

Emergency Medicine (EM)

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Ankle and foot X-Ray for patients with trauma

Emergency Medicine (EM)

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Cervical Spine Imaging Following Trauma

Emergency Medicine (EM)

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CT Abdomen for renal stones

Emergency Medicine (EM)

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CT head for patients with low-risk headache

Emergency Medicine (EM)

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maternity- Don’t do a cesarean delivery for the sole indication of failure to progress in the latent phase of laboring women at term with a singleton fetus.

Maternal-Fetal Medicine

maternity- Don’t prescribe progestogens for prevention of preterm birth in uncomplicated multifetal pregnancies

Maternal-Fetal Medicine

maternity- Don’t routinely exclude women with one low transverse cesarean delivery from having the choice to undertake a trial of labor after cesarean (TOLAC)

Maternal-Fetal Medicine

maternity- Don’t schedule an elective cesarean section in uncomplicated singleton pregnancies before 39 weeks gestation

Maternal-Fetal Medicine

maternity- Don’t start Aspirin, LMWH, and or Progesterone to maintain pregnancy in a patient with an unexplained recurrent pregnancy loss

Maternal-Fetal Medicine

maternity- Don’t use amniotic fluid index (AFI) to make a diagnosis of oligohydramnios after 28 weeks gestation

Maternal-Fetal Medicine

Baseline or routine CT for CLL

Hematology Medicine

Do not administer plasma or prothrombin complex concentrates for non-emergent reversal of vitamin K antagonists

Hematology Medicine

Do not order red blood cell folate levels at all. In adults, consider folate supplementation instead of serum folate testing in patients with macrocytic anemia

Hematology Medicine

Do not repeat hemoglobin electrophoresis (or equivalent e.g., HPLC) in patients who have a prior result and who do not require therapeutic intervention or monitoring of hemoglobin variant levels

Hematology Medicine

Do not test for thrombophilia in adult patients with venous thromboembolism (VTE) occurring in the setting of major transient risk factors

Hematology Medicine

Do not transfuse more than single unit to relieve symptoms of anemia or to return a patient to a safe hemoglobin range

Hematology Medicine

Don’t give IVIG as first line treatment for adult patients with asymptomatic idiopathic immune thrombocytopenia (ITP)

Hematology Medicine

Don't order thrombophilia testing in women with early pregnancy loss

Hematology Medicine

Don't transfuse red cells for Hematinic deficiency anemias without hemodynamic instability

Hematology Medicine

During interruption of warfarin anticoagulation for procedures, don't 'bridge' with full-dose low molecular weight heparin (LMWH) or unfractionated heparin (UFH) unless the risk of thrombosis is high

Hematology Medicine

Do not investigate or treat fecal pathogens in the absence of diarrhea or other gastro-intestinal symptoms

Pediatrics Infectious Diseases

Do not prescribe Macrolides as the first line therapy for Community Acquired pneumonia (CAP)

Pediatrics Infectious Diseases

Don’t order follow-up blood cultures (FUBC) in patients with gram negative bacteremia

Pediatrics Infectious Diseases

Don’t order multiple serological investigations

Pediatrics Infectious Diseases

Don’t order urine culture request with normal urine analysis

Pediatrics Infectious Diseases

Don’t routinely prescribing antibiotics for URI in children.

Pediatrics Infectious Diseases

Don’t Prescribe a Medication for Older Home Health Care Patients Without Conducting a Drug Regimen Review

Home Health Care

For Older Home Health Care Patients Avoid Using Medications Other Than Metformin to Achieve Hemoglobin A1c<7.5% In Most Older Adults; Moderate Control Is Generally Better

Home Health Care