Choosing Wisely is a clinician-led initiative enables clinicians and patients to collaboratively make choices for care that is evidence-based and truly necessary, leading to a reduction of occurrence of low-value care. In this project, BISI will be collaborating with NUHS Family Medicine and NUP to design the implementation of the Choosing Wisely Programme within NUHS by exploring the acceptability, feasibility and effectiveness of implementation strategies with a focus on uptake of, and fidelity to the Choosing WiselyTM programme by Family Medicine doctors and General Practitioners. This would involve:

1. An environmental scan of existing Choosing Wisely Programmes and other efforts to promote evidence based care to identify the key elements of a successful implementation
2. An analysis of barriers within the local setting to examine potential factors that may derail the implementation of the programme;
3. Working with key stakeholders and other experts on designing and prioritising of implementation strategies

Once the implementation strategies have been identified, BISI will also work with the stakeholders on planning a phased implementation of the programme and to evaluate the effectiveness of the programme at its various stages of implementations. The evaluation would involve using a hybrid effectiveness-implementation design appropriate for the evaluation of interventions that may have demonstrated effectiveness elsewhere but have not yet been implemented in another setting, context or with a different population. The outcomes of the programme will be measured by determining if the process of shared decision making between physicians and patients has improved and if the occurrence of low-value care within the healthcare system has been reduced.