Choosing Wisely For Critical Care: The Next Five

• Published in: Critical care medicine Vol. 49; no. 3; pp. 472 - 481
• Main Authors: Zimmerman, Jerry J., Harmon, Lori A., Smithburger, Pamela L., Chaykosky, Darlene, Heffner, Alan C., Hravnak, Marilyn, Kane, Jason M., Kayser, Joshua B., Lane-Fall, Meghan B., Matos, Renee I., Mauricio, Riza V., Murphy, David J., Nurok, Michael, Reddy, Anita J., Ringle, Eric, Seferian, Edward G., Smalls-Mantey, Norma M., To, Kathleen B., Kaplan, Lewis J.
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-03-2021
• Subjects: Clinical Decision-Making; Consensus; Critical Care - standards; Humans; Intensive Care Units; Practice Guidelines as Topic; Practice Patterns, Physicians' - standards; Quality of Health Care - standards; Societies, Medical - standards
• ISSN: 0090-3493; 1530-0293
• DOI: 10.1097/CCM.0000000000004876

To formulate new "Choosing Wisely" for Critical Care recommendations that identify best practices to avoid waste and promote value while providing critical care.
Semistructured narrative literature review and quantitative survey assessments.
English language publications that examined critical care practices in relation to reducing cost or waste.
Practices assessed to add no value to critical care were grouped by category. Taskforce assessment, modified Delphi consensus building, and quantitative survey analysis identified eight novel recommendations to avoid wasteful critical care practices. These were submitted to the Society of Critical Care Medicine membership for evaluation and ranking.
Results from the quantitative Society of Critical Care Medicine membership survey identified the top scoring five of eight recommendations. These five highest ranked recommendations established Society of Critical Care Medicine's Next Five "Choosing" Wisely for Critical Care practices.
Five new recommendations to reduce waste and enhance value in the practice of critical care address invasive devices, proactive liberation from mechanical ventilation, antibiotic stewardship, early mobilization, and providing goal-concordant care. These recommendations supplement the initial critical care recommendations from the "Choosing Wisely" campaign.