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Choosing Wisely helping young people make informed decisions

Choosing Wisely’s 5 Questions has proven itself an essential resource in helping people start conversations with their healthcare teams so they can better understand their care, but would it work for teenagers? That was the question that the Adelaide Women’s and Children’s Hospital asked themselves. The answer was ‘yes’ and with some tweaking, the hospital now has a highly popular and effective resource that resonates with young people while helping them take control of their health.

The Adelaide Women’s and Children’s Hospital is the largest provider of paediatric, maternity, and obstetric services in South Australia. Twenty per cent of its paediatric patients are aged between 15 and 18. This is an important group in terms of shared decision-making because in South Australia the age at which a person gives their own medical consent is 16 – two years younger than the rest of Australia. This is a group that requires a different communications approach to either adults or younger children.

Choosing Wisely’s 5 Questions promised to be an effective way of helping all patients ask questions and make informed decisions, but would it also be helpful for the younger age groups? The hospital was serious about finding ways to reach them.

A dedicated Choosing Wisely Project Officer, Julie Paholski, was appointed and a service-wide consultation process undertaken. Says Julie: “The feedback was that everyone loved the concept and they wanted to use it, but we needed to modify the imagery to be relatable to a younger audience.”

Detailed information was gathered, and ideas were canvassed through established hospital consumer groups that included a coffee club held for adults, parents and carers; a kids’ club for ages up to 13; and the hospital’s Youth Advisory Group formed of children and young adults aged between 13 and 24. Input was also sought from the hospital’s health literacy, consumer engagement, communications, and digital media teams as well as some nursing staff

The result was a series of bright, colourful posters and collateral that retained the Choosing Wisely Australia 5 questions wording intact with additional eye-catching imagery that was appealing to younger groups. These were displayed on digital screens and as posters throughout the hospital.

Choosing Wisely 5 Question wallet cards proved very popular, and many young people commented specifically on the value of having a take-away resource. The cards were resized as a double-sided business card in portrait format so they could easily fit into wallets.

Says Julie: “Now we had a great resource that caught people’s attention and we wanted to know if the introduction of structured questions was useful to our youth.”

A plan to conduct an anonymous survey on iPads, was thwarted by COVID restrictions, and alternative information collection methods had to be developed including a QR code and paper-based surveys. In the event, the most successful method was a personalised approach, in which a team member simply asked young people to complete the survey.

The survey results showed that:

  • 66 per cent of respondents thought the questions would be useful to help decide on their health care
  • 79 per cent thought the information cards should be provided to people on admission
  • 64 percent already had or planned to look at the Choosing Wisely website for further information
  • “It was helpful to see what I needed to ask.”
  • “It reminded me that you can ask questions.”
  • “It’s helpful for those who may be overwhelmed and not know what to say or ask.”

Young people said the 5 Questions helped them feel more comfortable asking questions.

Comments included:

  • “It was helpful to see what I needed to ask.”
  • “It reminded me that you can ask questions.”
  • “It’s helpful for those who may be overwhelmed and not know what to say or ask.”

This project is a good example of consumer engagement, working together with young people to help Choosing Wisely 5 Questions reach a younger audience and support young people to take control of their health.

Stewardship toolkit for clinical educators

The Health Resource Stewardship for Clinical educators contains educational material about the Choosing Wisely initiative for use in universities, hospitals and health professional colleges

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5 Questions

5 questions to ask your doctor or other healthcare provider to make sure you end up with the right amount of care.

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