Better Care Everywhere initiative

The Commission's new Better Care Everywhere initiative will bring together the wide range of guidance, tools and resources developed by the Commission to provide a comprehensive approach to promoting appropriate and sustainable health care.

Why is this important?

Appropriate care should see that patients receive the right type and amount of care, in the right place, at the right time. The care offered should also be based on the best available evidence.

Inappropriate care can be caused by a range of factors and a broad systematic approach is required to address these factors.

Ensuring appropriate care and minimising unnecessary investigations and treatments contributes to the sustainability of the health system by ensuring that valuable health resources are directed to where they're needed most.

What is the Better Care Everywhere initiative?

The Better Care Everywhere initiative will support the health system and promote high-value care pathways by describing what appropriate health care looks like. This will include:

Clinical governance

Clinical governance is central to providing the best outcomes for patients. The Commission is creating a new national clinical governance framework. This will reflect contemporary governance thinking and best practice to support health service organisation leaders deliver high-quality care.

Related clinical governance resources include:

National Model Clinical Governance Framework

National standards

The value of monitoring clinical variation is now reflected in the National Safety and Quality Health Service (NSQHS) Standards. Developed by the Commission in collaboration with the Australian Government, states and territories, the private sector, clinical experts, patients and carers, the NSQHS Standards aim to minimise the risk of harm to patients and improve the quality of health service provision.

Within the NSQHS Standards, Action 1.28: Variation in clinical practice requires health service organisations to have systems in place that use data to monitor variation in care to identify unwarranted variation and to regularly review and improve the appropriateness of clinical care.

A related action and resource includes:

Action 1.28 from the NSQHS Standards

Environmental Sustainability and Climate Resilience Healthcare Module

Clinical guidance

Clinical guidance describes the care that patients can expect to be offered by clinicians and healthcare services for a specific clinical condition, treatment, procedure or clinical pathway, regardless of where they are treated in Australia. Clinical Care Standards are a type of clinical guidance developed to address high priority areas for quality improvement based on evidence of unwarranted variation.

Clinical guidance includes:

Clinical Care Standards

Quality Use of Medicines

Infection Prevention and Control

Patient guidance

The Commission supports clinicians and health service organisations in understanding the value of partnerships and engagement with patients, carers and families and to integrate person-centred approaches through the Partnering with Consumers Standard, and through the development of supportive resources.

Information supporting consumer partnerships include:

Shared decision making

Person-centred care

Informed consent

Australian Charter of Healthcare Rights

Data and reporting

Under the Better Care Everywhere initiative the Commission is aligning its data and reporting offerings to provide data to the health system from a national, state and territory, Primary Health Network and a local area perspective based on where people live. Along with detailed data for general practitioners to review how their clinical practice may vary from their peers and be contributing to unwarranted clinical variation.   

Aligned reporting across:

Australian Atlas of Healthcare series reports

MedicineInsight reports

Antimicrobial Use and Resistance in Australia (AURA) Project

Benefits of the new initiative

A focus on national safety and quality priorities
Linking priority programs across the Commission to provide coordinated resources where they're needed most.
Easy to find information
All of the Commission's appropriate and sustainable health care resources available in one easy-to-find location.

New tools and resources
Resources to support consumers, clinicians and health services to reduce clinical variation.
Increased collaboration
Foster new partnerships and consultations with organisations across the health system.

Recent work under the Better Care Everywhere initiative

Heavy Menstrual Bleeding

In 2024, the Commission launched the Heavy Menstrual Bleeding (HMB) campaign with the goal to improve the range of choices available to women with HMB and ensure they are offered the most appropriate and least invasive treatment for their individual situation. The campaign included the release of the:

Women's Health Focus Report
Includes trend data from the Atlas in a new interactive report examining rates of hysterectomy and endometrial ablation.
Revised Heavy Menstrual Bleeding Clinical Care Standard
An updated CCS with the latest guidance on optimal patient care.

This coordinated release provided health service organisations, policy makers and clinicians insight into where further efforts are needed along with updated clinical guidance modelling the appropriate pathway of care.

Chronic Obstructive Pulmonary Disease

A coordinated focus across several of the Commission’s program areas provides a range of new resources to identify and address unwarranted variation in the treatment of Chronic Obstructive Pulmonary Disease (COPD).

COPD Clinical Care Standard
Released in October 2024, the Chronic Obstructive Pulmonary Disease (COPD) Clinical Care Standard aims to reduce potentially preventable hospitalisations and improve overall outcomes for people with COPD by supporting best practice in the assessment and management of COPD, including exacerbations.
MedicineInsight GP Snapshot: COPD
The MedicineInsight GP Snapshot on COPD provides essential data and practical insights to help GPs improve the diagnosis and management of COPD.
Atlas COPD Focus Report
Due for release in mid-2025, the COPD Focus Report will map and identify variation in the management of COPD across Australia at a national, state and territory, Primary Health Network and local level.

Heavy Menstrual Bleeding

Women's Health Focus Report
Includes trend data from the Atlas in a new interactive report examining rates of hysterectomy and endometrial ablation.
Revised Heavy Menstrual Bleeding Clinical Care Standard
An updated CCS with the latest guidance on optimal patient care.

Chronic Obstructive Pulmonary Disease

COPD Clinical Care Standard
Released in October 2024, the Chronic Obstructive Pulmonary Disease (COPD) Clinical Care Standard aims to reduce potentially preventable hospitalisations and improve overall outcomes for people with COPD by supporting best practice in the assessment and management of COPD, including exacerbations.
MedicineInsight GP Snapshot: COPD
The MedicineInsight GP Snapshot on COPD provides essential data and practical insights to help GPs improve the diagnosis and management of COPD.
Atlas COPD Focus Report
Due for release in mid-2025, the COPD Focus Report will map and identify variation in the management of COPD across Australia at a national, state and territory, Primary Health Network and local level.

Stay updated on the Better Care Everywhere initiative

Your input is vital in shaping the future of the Better Care Everywhere initiative. Stay informed by signing up to the Commission's newsletter.

Commission resources supporting appropriate and sustainable health care

Below is a list of resources developed by the Commission that can be used to support the delivery of appropriate and sustainable health care.

Topic	Commission Resource
Clinical guidance	Clinical Care Standards Evidence based guidance to support the delivery of appropriate and high-quality health care for 19 topics Some examples include: Heavy Menstrual Bleeding Chronic Obstructive Pulmonary Disease Antimicrobial Stewardship Colonoscopy Delirium Sepsis Management of Peripheral Intravenous Catheters Low Back Pain Opioid Analgesia Stewardship in Acute Pain Osteoarthritis of the knee Venous Thromboembolism Prevention
	Topic Specific Decision Support Tools 7 clinical topics to aid clinicians and consumers to guide shared decision making including: Sinusitis: Should I take antibiotics?  COPD exacerbation: Should I take antibiotics?  Do I really need antibiotics? Sore throat: Should I take antibiotics? Middle ear infection: Should my child take antibiotics? Acute bronchitis: should I take antibiotics?
	Other resources include: Australian Atlas of Healthcare Variation Opioid Time Series report  Women’s Health Focus Report
Consumer resources	Topic specific resources: Guides created to inform and empower consumers Acute Stroke Clinical Care Standard Consumer Guide  Antimicrobial Stewardship Clinical Care Standard Consumer Guide  Colonoscopy: what you need to know  Low Back Pain Clinical Care Standard Consumer Guide  Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard Guide for Consumers  Sepsis Clinical Care Standard Information for Consumers  Stillbirth Clinical Care Standard Information for Consumers  Third and Fourth Degree Perineal Tears Clinical Care Standard Information for Consumers  Venous Thromboembolism Prevention Clinical Care Standard Consumer Guide  Information for consumers - Opioid Analgesic Stewardship in Acute Pain Clinical Care Standard   Patient information and shared decision-making statement for nonpharmacological and pharmacological options Acute Coronary Syndromes Clinical Care Standard Consumer Fact Sheet
	Top Tips for Safe Health Care A 12-page document with practical tips to help consumers get the most out of their health care
	Australian Charter of Healthcare Rights A one-page poster outlining consumers rights when accessing health care
	Partnering with Consumers: A guide for consumers A guide on how to build and strengthen consumer partnerships at all levels of the health system
	Shared decision making Videos and webinars to support shared decision making
	The Commission uses case studies to highlight exemplar health services or initiatives. For example, Partnering with Consumers showcased a health service for their patient-centered approach
Sustainability focus	Environmental Sustainability and Climate Resilience Healthcare Module A draft framework of actions that health services can use to ensure their services are improving the safety and quality of care while addressing the health impacts of climate change and health care’s contribution to climate change
	Joint Statement on Climate Change and Health A collaborative commitment between 19 organisations to address the health impacts of climate change
	Sustainable glove use for healthcare workers Fact sheet to promote appropriate use of gloves
Identifying clinical variation to promote high quality care	User Guide for Reviewing Clinical Variation A six-step approach to enable health services to review clinical variation and reduce unwarranted variation
Antimicrobial use	Antimicrobial Use and Resistance in Australia (AURA) Program monitoring antibiotic prescriptions in Australia
	Asymptomatic bacteriuria: reducing inappropriate antimicrobial prescribing for aged care facility residents A fact sheet and decision support tool to promote appropriate antimicrobial use in aged care facility residents
	Information for consumers on antimicrobial resistance Information for consumers to increase awareness of antimicrobials and the role they can play in preventing resistance

What does this mean for Choosing Wisely Australia?

The Choosing Wisely Australia program played an important role in initiating a national dialogue on reducing unnecessary tests, treatments and procedures. This work laid the foundations for broader systems approaches that can consolidate and extend the benefits of reducing low-value care.

After careful consideration, the Commission will retain ownership of the Choosing Wisely Australia brand, but its recommendations and resources will not be actively updated.

The Commission will instead focus on the Better Care Everywhere initiative which builds on the principles of Choosing Wisely while incorporating the Commission’s existing programs of work. This will involve promoting models of appropriate care and delivering resources to the health system to support their implementation.

The Commission will continue to work closely with clinicians, clinical colleges, patients and communities. This includes the recently established Health College Working Group on Climate Change and Health and the development of a Framework for Collaborative Action in response to Action 4.8 in the National Health and Climate Strategy.

The Commission encourages clinical colleges and health service organisations to continue to identify ways to reduce unnecessary tests and procedures.

Choosing Wisely - frequently asked questions

What is happening with the Choosing Wisely Australia program?

The goal of Choosing Wisely Australia was to promote a national dialogue on unnecessary tests, treatments and procedures. The Commission recently signed a Joint Statement on Climate Change and Health, which all specialist medical colleges and the Australian Indigenous Doctors’ Association have endorsed. This statement demonstrates all parties’ commitment to reducing the health impacts of climate change with a range of strategies, including reducing potentially harmful and wasteful care. The Commission will continue to retain ownership of the Choosing Wisely brand but will not actively update its recommendations or resources on the website.

With the need for a broader systems approach to appropriate and sustainable care, the Commission will focus on the Better Care Everywhere initiative. This new initiative builds on the principles of Choosing Wisely while incorporating the Commission’s programs of work on Clinical Governance, Clinical Care Standards, Healthcare Variation, Medicines Safety and Infection Prevention and Control, and Partnering with Consumers. It aims to provide an integrated approach to improving the appropriateness and sustainability of health care.

What has informed this decision?

Stakeholder consultation and a range of quantitative and qualitative data was used to inform the shift from Choosing Wisely to the Better Care Everywhere initiative. These include:

A review of the Choosing Wisely website and resources, including a mapping exercise which identified suitable alternatives developed by the Commission.
Feedback from consultation with key stakeholder groups, including the Choosing Wisely Advisory Group established under NPS MedicineWise.
Feedback received during the Multi-College Roundtable on Climate Change and Health hosted in June 2024 by the Commission in partnership with the interim Australian Centre for Disease Control.
Approaches taken by the American Board of Internal Medicine (ABIM) Foundation, who were the initiators of the original Choosing Wisely program, and the Health Quality and Safety Commission in New Zealand.

Will the Choosing Wisely recommendations and resources still be available?

Yes, recommendations and resources developed as part of the Choosing Wisely Australia program will be available on the Choosing Wisely website during the transition period, until December 2025. However, these recommendations and resources will not be updated.

The Commission will be liaising with the respective medical colleges who own the recommendations to identify what they plan to do with them, as we develop a Framework of Collaborative Action to support the implementation of the National Health and Climate Strategy.

The recommendations were clinician-led and supported by evidence available at the time. As evidence is constantly evolving, the Commission is unable to guarantee that the recommendations on the Choosing Wisely website are in line with current best practice.

Key resources such as the 5 questions resource, guide for answering the 5 questions, Junior Medical Officers Toolkit, Hospital Implementation toolkit and the Medico-legal risks and low-value care module will be available on the Commission website during this transition period.

Can clinical colleges, societies and associations produce their own recommendations?

The Commission encourages health professional colleges, societies and associations to continue to identify and reduce unnecessary tests and procedures.

The Commission will be involved in leading the Framework for Collaborative Action alongside the interim Australian Centre for Disease Control, to meet certain actions in the National Health and Climate Strategy. The Health College Working Group on Climate Change and Health will be focusing their attention on appropriate pathways of clinical care.

Can I still use the Choosing Wisely logo in my quality improvement initiatives?

Can I still use the 5 questions resource?

Who owns the Choosing Wisely brand now in Australia?

What happens to my Choosing Wisely Membership?

What happens to Choosing Wisely Champion Health Services?

Who can I contact at the Commission for more information?