American Society of Hematology

American Society of Hematology to Recognize Choosing Wisely Champions at 59th Annual Meeting

Published on: December 11, 2017

(WASHINGTON, December 11, 2017) – The American Society of Hematology (ASH) will recognize three Choosing Wisely® Champions, practitioners working to tackle overuse of hematology tests and treatments, today at its 59th annual meeting in Atlanta.

Choosing Wisely is a program of the ABIM Foundation and Consumer Reports that aims to prompt conversations between patients and clinicians about the necessity and potential harm of certain procedures. As a part of this initiative, ASH has identified 15 commonly used tests, treatments, and procedures in hematology that clinicians and patients should question in certain circumstances to avoid overuse, waste, and harm. Choosing Wisely Champions, an initiative of the ABIM Foundation, recognizes clinicians who have implemented successful projects to improve quality at their institutions and advance the goals of the campaign.

The three ASH Choosing Wisely Champions will speak at a Special-Interest Session at the 2017 ASH Annual Meeting, allowing the Society to recognize their efforts and provide attendees with an opportunity to learn about projects that might be translated to their own practices.

“At this year's Choosing Wisely Session we will be showcasing three outstanding initiatives that tackle different types of overutilization with strategies that are elegant in their relative simplicity.” said Lisa Hicks, MD, of St. Michael’s Hospital and the University of Toronto and chair of the ASH Subcommittee on Stewardship, which selected the winners. “It is our hope that members of the ASH community will be inspired by these projects to address overutilization in their own health care settings.”

The 2017 ASH Choosing Wisely Champions are:

Matthew Schefft, DO, Children’s Hospital of Richmond at Virginia Commonwealth University 

Vaso-occlusive crisis (VOC) is a frequent event for children with sickle cell disease (SCD) and creates a significant burden on patients, families, and emergency departments (ED). The objective of Dr. Schefft’s project was to reduce the admission rate for children with SCD presenting to the pediatric ED with VOC by more than 20 percent within six months of initiating Individualized Pain Plans (IPP). Dr. Schefft’s study measured the presence of an IPP, adherence to the IPP, and time to first and second opiate dose administration. Dr. Schefft and his colleagues demonstrated that IPPs provide an effective strategy to reduce the admission rate for children with SCD presenting with VOC and that shorter time to second opiate dosing was also associated with a reduced risk of admission. 

Yulia Lin, MD, Sunnybrook Health Science Centre/Research Institute, Toronto, Ontario 

Dr. Lin’s project was developed after it was observed that a patient with ongoing menorrhagia and anemia had been repeatedly transfused multiple RBC units in the emergency department (ED). Dr. Lin and her colleagues realized that the management of iron deficiency anemia, especially in asymptomatic patients, could be improved from the baseline by better usage of oral and IV iron over RBC transfusion. Dr. Lin’s team performed a baseline audit in 2013 which determined that, of patients transfused for IDA, only 53 percent fell in the category in which transfusion was appropriate as a first-line measure. Moreover, the audit confirmed that iron supplementation was infrequently used. To combat these deficiencies, Dr. Lin and her colleagues developed and implemented a series of interventions, including conducting an education session for ED physicians, making intravenous iron more readily available in the ED, developing an algorithm on IDA management targeted for the ED environment, improving access to a transfusion specialist for guidance, presenting this quality improvement project at rounds, and implementing a toolkit geared toward ED physicians. The result of these interventions was a significant improvement over the baseline, with RBC transfusion appropriateness improving from 53 percent to 91 percent between January 2014 and December 2015, while the use of IV iron increased from one use over the initial three-month audit period to an average of 2.4 uses per month in 2014 and 4.8 per month in 2015. This led to improved care and reduced costs. 

Marc S. Zumberg, MD, University of Florida 

Dr. Zumberg and his team developed their project on compliance and usage of recombinant VIIa, prothrombin complex concentrates (PCCs), and blood products after it was noted that the hospital had numerous instances of off-label use of these products. Working with the College of Pharmacy and the blood bank, Dr. Zumberg and his colleagues developed institutionally approved indications for use of these products, and simultaneously developed guidelines for the immediate reversal of anticoagulant-related bleeding for patients on anticoagulants needing emergency surgery. Over the span of three years the project accounted for adjusted reductions of $590,830 for expenditures associated with use of VIIa and PCCs outside of the pharmacy and therapeutics committee-approved criteria for use. The campaign has also been very successful at increasing compliance with the University of Florida’s blood transfusion guidelines.

Drs. Schefft, Lin, and Zumberg will present their successful usage strategies during the ASH Choosing Wisely Campaign: 2017 ASH Choosing Wisely Champions session at the 2017 ASH Annual Meeting on Monday, December 11, 2017, at 12:15 p.m. EST in Bldg C- Lvl 2- C202-C204 of the Georgia World Congress Center.


About ASH:

The American Society of Hematology (ASH) (www.hematology.org) is the world's largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment, and prevention of disorders affecting the blood. For more than 50 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology. The Society publishes Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field, as well as the newly launched, online, open-access journal, Blood Advances (www.bloodadvances.org).

About the ABIM Foundation

The mission of the ABIM Foundation is to advance medical professionalism to improve the health care system. We achieve this by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policy makers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, read the ABIM blog blog.abimfoundation.org, or connect with ABIM on Facebook and Twitter.

About Choosing Wisely®

First announced in December 2011, Choosing Wisely® is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. Participating specialty societies are working with the ABIM Foundation and Consumer Reports to share the lists widely with their members and convene discussions about the physician’s role in helping patients make wise choices. Learn more at www.ChoosingWisely.org.

CONTACT:
Sara Khalaf, American Society of Hematology
skhalaf@hematology.org; 202-552-4925

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