RACP and the Evolve initiative

The EVOLVE initiative reflects The Royal Australasian College of Physicians' (RACP) commitment to a high quality, safe and sustainable health care system.

EVOLVE encourages each medical specialty to think about the clinical circumstances in which some of their practices, whether they are medical tests, procedures and interventions, should have their indications or value questioned and discussed by physicians. These practices may be overused, inappropriate or of limited effectiveness in a given clinical context.

By working in partnership with Specialty Societies, this peer-led initiative aims to create a list of the top 5 ‘low value' practices used in commonly encountered clinical scenarios which are within the area of expertise of each of the RACP's more than 30 specialties. The items identified might be included because there is new evidence showing their lack of effectiveness in a given context or for a particular patient population. Based on these lists, The College will work with the medical profession and community to promote the recommended changes in clinical practices.

International experience stresses the importance of this work being led by the medical profession.¹  Medical journals such as JAMA Internal Medicine also highlight that transparent methods are fundamental when looking to identify interventions, procedures, tests and treatments "that cause potential harm or provide little benefit to patients, are frequently misused in clinical practice, are measurable, and are under the control of the providers".²  

The title EVOLVE reflects the dynamic nature of medicine; where practices improve as a result of past knowledge and experience. It also describes how this initiative takes practice improvements further, by focusing on effective and efficient use of resources in this evidence-based era.

For more information please contact Jason Soon at Jason.Soon@RACP.edu.au or +61 2 9256 9615.

References

1.  Morden NE, Colla CH, Sequist TD, Rosenthal MB 2014. Choosing wisely: the politics and economics of labeling low-value services. New Engl J Med; 370(7):589-592.

2.  Grady D, Redberg RF, Mallon WK 2014. How should top-five lists be developed? What is the next step? JAMA Internal Medicine: 174(4):498-499.