title: Choosing Wisely? Let's Start with Working Wisely.
abstract: There is an increasing emphasis on quality and, relatedly, cost-effectiveness as it relates to the delivery of health care. Choosing Wisely is an initiative adopted by numerous specialties with the goal of starting a dialogue about efficient use of health care resources. People need to be able to access care to have an opportunity to choose wisely. There is a considerable amount of evidence that access to care is poor for specialty mental health care, particularly access to psychiatrists. Consequently, we suggest that psychiatrists and the broader mental health system need to consider working wisely, and in our paper outline key issues (for example, implementation of wait times and objective measures of need in a centralized referral management system; incorporation of performance indicators with longitudinal monitoring for continuous quality improvement) that need to be addressed to develop a mental health system that would allow people to access care to choose wisely.
authors: Department of Psychiatry, University of Toronto, Toronto, Ontario paul.kurdyak@camh.ca.
authors: Paul
authors: P
authors: Kurdyak
authors: Department of Psychiatry, University of Toronto, Toronto, Ontario Mount Sinai Hospital, Toronto, Ontario.
authors: Lesley
authors: L
authors: Wiesenfeld
authors: Department of Psychiatry, University of Toronto, Toronto, Ontario University Health Network, Toronto, Ontario.
authors: Sanjeev
authors: S
authors: Sockalingam
mesh_terms: D002170:Canada; D019317:Evidence-Based Medicine / Q000592:standards*; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008605:Mental Health Services / Q000592:standards*; D057240:Patient Preference; D011787:Quality of Health Care / Q000592:standards*
keywords: Choosing Wisely; access to care; evidence-based medicine; health service delivery