Table 2

Key elements of a choosing Wisely campaign

High-level goalConcrete objectivesAssociated activitiesPlanned outputsAnticipated outcomesMeasurement approaches
To reduce unnecessary care, harm and wasteChange physician attitudes to clinical practiceRaise physician awareness of the issue of unnecessary careMedical journal article, news stories, interviewsReceptivity to learning how to approach unnecessary care in daily practicePhysician baseline attitude survey
Engage physicians in list development and implementationIncreased number of specialties sign onMembers of specialties buy-into the initiativePhysician survey and interviews of attitudes
Educate by inclusion in undergraduate and postgraduate teaching and in continuing professional developmentEducational materials for use in medical schools and for continuing professional developmentInformed trainees and practitioners confident in discussing unnecessary care with patientsDocumented curriculum inclusion in medical school, residency programmes, and continuing education
Foster patient engagement and acceptance‘More is not better’ public messagingPublic service messages, posters, social media campaignPublic awareness of the issue of unnecessary carePatient survey of awareness and acceptability of messaging
Develop partnerships with patient and public organisationsFeatures in partner newsletters and on web sitesPatient and public gain confidence in the campaignPatient surveys and interviews of attitudes
Change key clinical practicesPromote increased shared decision makingIncreased frequency of discussions about necessityIncorporation of shared decision making in practicePatient surveys of care experiences
Follow Choosing Wisely lists in practiceBetter fit between need and careReduced unnecessary careMeasurement of rates of necessary and unnecessary care for select services
Promote alignment with the healthcare systemRecruit partners among clinics, hospitals, regions and othersIncorporation into standard orders and clinical support systemsEnhanced adherence to Choosing Wisely guidanceAudit of clinical performance in a healthcare setting or region
Advocate for fit with payment systemAdjusted fee codesReduced incentives for overuseservices Measurement of rates of necessary and unnecessary care for select