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ASH to Recognize Choosing Wisely Champions at 61st Annual Meeting

(WASHINGTON, Nov. 26, 2019) – The American Society of Hematology (ASH) will recognize three Choosing Wisely® Champions, practitioners working to tackle overuse of hematology tests and treatments, at its 61st ASH Annual Meeting in Orlando.

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 on Monday, December 9, at the 2019 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.

“Choosing Wisely is an opportunity to highlight great implementation efforts that help improve the quality of care for our patients and to honor individuals who dedicated time and research to tackle different types of overutilization with elegant, implementable strategies,” said Anita Rajasekhar, MD, of the University of Florida and chair of the ASH Subcommittee on Stewardship and Systems-Based Hematology, which selected the winners. “Education alone and awareness alone are not enough, and so I have no doubt that these three exemplary champions will motivate others to follow their lead.”

The 2019 ASH Choosing Wisely Champions are:

Stephen L. Wang MD, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California
“Reduction in IVCF Utilization and Increase in IVCF Retrievals”

Fourteen CME-approved in-hospital grand rounds covering evidence-based review of the inferior vena cava filter (IVCF) efficacy, guidelines, and complications were performed at 14 medical centers across a large U.S. health care region. Physician attendance was recorded and a computer-based IVCF tracking system was deployed simultaneously. IVCF use, rates of retrieval, and fulfillment of guidelines were evaluated for 12 months pre and post intervention. Following this educational campaign, IVC filter utilization was decreased and IVC filter retrieval was increased. This project focuses on education to change long-held practice patterns and leveraging new technology to improve tracking and follow-up of these potentially risky devices.

Rachael Grace MD, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
“Recommendations for Newly Diagnosed Children with Immune Thrombocytopenia (ITP)”

The recommendation for an observational approach in newly diagnosed children with ITP that was highlighted in the 2014 ASH Choosing Wisely Campaign has been adopted by Boston Children’s Hospital with some variations proving to be highly effective in aiding management and treatment decisions for this population. A modifiable practice guideline was established in 2012, and since its inception it has unified the center’s initial laboratory approach, pharmacologic treatment, and timing of follow-up for all newly diagnosed children with ITP. When no impact on observation rates was made, a second iteration of the guideline was implemented. This version was modified to stratify low- and high-risk grade 3 bleeding. With this change, observation rates have increased from 40% to 74% with no increase in bleeding complications. A toolkit for this project includes the management algorithm for newly diagnosed children with ITP, data collection forms, and the elements of a REDCap database.

Jordan Schaefer MD, University of Michigan, Ann Arbor, Michigan
“Warfarin Monotherapy in Place of Combination Therapy of Aspirin and Warfarin”

Because guidelines advocate for warfarin monotherapy rather than combination therapy with warfarin and aspirin (ASA), the Michigan Anticoagulation Quality Improvement Initiative (MAQI2) implemented a common intervention to reduce the inappropriate use of aspirin. Each of the six participating sites used a tailored screening process to identify potential inappropriate ASA use based on an agreed-upon set of criteria. If the indication for a patient’s ASA use was unclear or potentially inappropriate, their primary care provider was alerted to prompt a discussion about the patient’s ASA use. To allow for local tailoring of the intervention, the various sites differed in the personnel carrying out the intervention, how technology was used, and how providers were contacted. Monthly assessments of inappropriate aspirin use were conducted, and an “Anticoagulation Toolkit” has been developed.

Drs. Wang, Grace, and Schaefer will present their successful utilization strategies during the ASH Choosing Wisely Campaign: 2019 ASH Choosing Wisely Champions session at the 61st ASH Annual Meeting on Monday, December 9, 2019, at 12:15 p.m. EST in Tangerine 1 (WF1), Level 2 of the Orange County Convention 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 60 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology. ASH publishes Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field, and Blood Advances (www.bloodadvances.org), an online, peer-reviewed open-access journal.

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.

Sara Khalaf, American Society of Hematology 
[email protected]; 202-552-4925