Evidence-Based Practice

Choosing Wisely®

Choosing Wisely

An update on AOTA's best practice recommendations (formerly Choosing Wisely®)

From 2018 - 2021, AOTA published 10 best practice recommendations as part of the Choosing Wisely campaign. The campaign aimed to promote meaningful conversations between practitioners and clients and ensure quality health care that is efficacious and cost-effective. Choosing Wisely was a partnership between the American Board of Medicine (ABIM) Foundation and specialty societies and was active in generating clinical recommendations from 2012-23. Going forward, the ABIM Foundation is switching focus away from developing and maintaining recommendations through Choosing Wisely.

Though the recommendations will no longer be available on the Choosing Wisely website, they will be available directly through AOTA. We will continue to review the recommendations annually to ensure that they are representative of current evidence and best practices.

The development of these recommendations was a member-driven initiative and they have provided value to practitioners, consumers, and policymakers. Together with a review board of members and stakeholders, we will determine our next steps for the initiative and communicate this to AOTA members.

Implement & share the recommendations

We encourage you to not only apply the findings from the initiative to practice but also to share the recommendations. You can do this by

  • starting conversations with colleagues about the necessity of practice improvement,
  • utilizing conferences, social media, in-services, or other forums to spread the word,
  • and leading by example in your own practice and leadership in your workplace.

Recommendations

How was the list developed?

Initial recommendation development (published in 2018)

Led by Project Champion Glen Gillen, EdD, OTR, FAOTA, then Associate Director and Professor of Rehabilitation and Regenerative Medicine (Occupational Therapy) at Columbia University Medical Center, AOTA conducted a three-phase project to develop the initial 5 Choosing Wisely recommendations of services that occupational therapy practitioners should not provide. The phases of the project included Phase I—building member awareness and support, Phase II—soliciting member input, and Phase III—disseminating the final items.

  • Phase I was accomplished through presentations to AOTA member and volunteer groups, a Town Hall session at the 2017 AOTA Annual Conference, an online webinar and related materials, and coverage in AOTA publications. Phase I included an initial online member survey that resulted in 328 responses. Following the elimination of duplicate responses and items outside the scope of occupational therapy practice, the list was narrowed down to 62 items. Additional input was received from AOTA Special Interest Section volunteer leaders to rank the items based on established criteria. An extensive literature search was conducted on the highest-ranked strategies.
  • Phase II involved an online member survey presenting 12 items for evaluation, with a goal of picking the top 5. This survey resulted in 4,860 responses that were analyzed, resulting in the final 5 items. These items were reviewed by the AOTA Board of Directors.
  • Phase III included the development of a communication and dissemination plan. The first step was a Town Hall at the 2018 AOTA Annual Conference & Expo.
Additional recommendation development (published in 2021)

In 2020, AOTA initiated the process to develop additional recommendations. The process to select and refine the recommendations followed the same member survey and selection process used in 2018:

  • An online member survey included interventions originally identified but not selected in the 2018 survey.
  • Respondents selected up to 5 out of 10 items for the development of additional recommendations.
  • The survey received 999 responses that were analyzed, resulting in 7 highly ranked selections.
  • These selections, along with a write-in suggestion identified in multiple surveys, were ranked by AOTA Special Interest Section (SIS) Standing Committees.
  • Members of the AOTA Evidence-Based Practice team, and Program Champion Glen Gillen, EdD, OTR, FAOTA, current Professor and Director, Programs in Occupational Therapy at Columbia University, reviewed the results from the member survey, compared the SIS rankings, and selected the top 5 items.
  • The team conducted a final literature review for each item and developed recommendations in collaboration with AOTA staff members and member content experts.

If you have any questions or comments about the campaign, contact ebp@aota.org.