Improving healthcare value: Reducing overuse in hospital pediatrics

Choosing Wisely in pediatric healthcare: A narrative review

“…Doing more feels safer because it alleviates uncertainty, particularly when the stakes are high: families might pressure pediatricians to prescribe drugs or perform tests that might not be indicated. In pediatrics, there is even higher anxiety for both parents and frontline clinicians around diagnostic uncertainty of any kind when it comes to children ( 43 ).…”

“…The main principles of implementation included targeted education/awareness and transparent measurement with audit/feedback. Most importantly, the changes need to be integrated into the ordering process to make it easier for frontline physicians ( 43 ). Evaluating whether CW initiatives work is the first point in assessing whether the effort is “worth it.” Determining the impact of CW campaigns is challenging and requires a comprehensive multi-pronged approach, as proposed by Bhatia et al .…”

“…Doing more feels safer because it alleviates uncertainty, particularly when the stakes are high: families might pressure pediatricians to prescribe drugs or perform tests that might not be indicated. In pediatrics, there is even higher anxiety for both parents and frontline clinicians around diagnostic uncertainty of any kind when it comes to children (43). Other non-scientific factors, such as clinical traditions, pressure from colleagues or the peer-review process, and fear of legal consequences, contribute to the common practice of "defensive medicine," and the large availability of tests and treatment may be responsible for the habit of excessive use of medical care even by pediatricians (7).…”