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It is not recommended to transfer a palliative patient to a facility far from their friends and family without considering if their goals of care can be achieved locally.
Choosing Wisely Canada
Public Health Physicians of Canada
Advanced care planning is an important part of primary care to establish individual patient’s goals of care. This is especially true for rural patients who may need to be transferred to an alternate community for care. Studies have shown that rural patients prefer to die in their home communities. It is important to consider the patient’s goals when contemplating sending them away from the community for medical treatment at the end of life. If the patient is transferred to an alternate ...
ver más ... 2020It is not recommended to order imaging to distinguish acute bacterial sinusitis from an upper respiratory infection.
Choosing Wisely Canada
Canadian Society of Otolaryngology–Head & Neck Surgery, Pediatric Otolaryngology Subspecialty Intere
Acute bacterial sinusitis (ABS) is a diagnosis that is made based on clinical criteria and has a low prevalence amongst children presenting with respiratory symptoms. Although a normal radiograph, CT, or MRI can help to rule out ABS, an abnormal result does not confirm the diagnosis. Given that many children will have abnormal imaging due to a viral upper respiratory infection during certain times of the year, combined with the potential for exposure to radiation, routine imaging is not ...
ver más ... 2020It is not recommended to send a low risk patient to a distant centre for a screening test (i.e. mammography) if the risk of injury from transportation to the centre is higher than the benefit of the ...
Choosing Wisely Canada
Society of Rural Physicians of Canada
In 2018, for every billion kilometers travelled by a motor vehicle in Canada there were 4.9 fatalities and 390 total injuries (including 24.2 serious injuries). The risk of travel in rural communities is greater than urban areas. Despite rural areas accounting for only 18% of the population, 54% of fatal motor vehicle collisions in Canada occur on rural roads. The danger of rural roads has been attributed to multiple factors including greater distances to medical facilities, inclement weather, ...
ver más ... 2020It is not recommended to order routinely a plain film x-ray in the evaluation of pediatric nasal fractures.
Choosing Wisely Canada
Canadian Society of Otolaryngology–Head & Neck Surgery, Pediatric Otolaryngology Subspecialty Intere
Nasal fractures are one of the most common facial fractures in the pediatric population. The decision to perform a closed reduction procedure in the operating room is based on factors such as breathing difficulty and external deformity, which are not assessed effectively by x-ray. Plain film x-rays are unable to accurately evaluate nasal fractures given its low sensitivity and specificity, at 72% and 73% respectively. Physical examination is often sufficient to make a diagnosis for children ...
ver más ... 2020It is not recommended to send a patient for a specialist visit that requires several hours of transport if the visit can be done virtually or by a local physician.
Choosing Wisely Canada
Society of Rural Physicians of Canada
Due to the location of many rural communities, it is very challenging for rural patients to easily access many specialist physicians who typically practice in more urban centres. Travel away from a community removes patients from their support systems, induces financial burdens and can create safety concerns for patients, especially in the winter months. Telemedicine provides a cost-effective solution to improve access to care closer to home. Thus, if the option is available, and in ...
ver más ... 2020