Choosing Wisely

Our goal is simple: the right care, at the right time, for the right patient.

Choosing Wisely began as a global movement to reduce low value care: tests, treatments and procedures that offer patients little to no benefit. Launched in the United States in 2012 and now adopted in more than 30 countries, the movement was introduced at SGH in mid-2023 and expanded across all SingHealth institutions by 2025.

(a)  Our approach: appropriateness, not just reduction

SingHealth’s Choosing Wisely is built on a broader principle of appropriate care: a culture of thoughtful decision making that addresses both the overuse and underuse of care.

Before a test, treatment or procedure is carried out, healthcare teams consider whether it is the best option for that patient. This helps avoid unnecessary care while ensuring that important care is not overlooked.

By supporting thoughtful and informed decision-making, Choosing Wisely helps match care to what each patient needs, at the right time and in the right setting.

(b)  Patients first, always

Improving patient outcomes and experiences is at the heart of Choosing Wisely. When care is appropriate, patients can avoid unnecessary procedures, reduce potential risks, and focus on treatments that are most likely to benefit them. At the same time, healthcare teams can make better use of available resources and devote more time to care that has the greatest impact.

Healthcare sustainability (Environment, Economic, Equity) follows as a co-benefit of this culture, not its goal. We draw this distinction deliberately. Choosing Wisely is not about cutting costs or limiting access to care. It is about helping patients receive the most appropriate care based on their individual needs, while supporting a high-quality and sustainable healthcare system.

(c)  One movement, not two

Around the world, initiatives that focus on improving healthcare outcomes and reducing unnecessary care are often run separately. At SingHealth, we take an integrated approach by bringing these efforts together under a common strategy.

Choosing Wisely is closely linked with our VDC programme and the patient feedback we collect through PROMs. This allows us to understand not only whether care is appropriate, but also how it affects patients' health and well-being.

By connecting these programmes, we gain a more complete picture of the quality and value of care delivered. This helps healthcare teams make improvements that matter most to patients and supports better outcomes across the care journey.

This matters because by measuring outcomes, listening to patients, and promoting appropriate care, we can ensure that improvement efforts work together towards a common goal: delivering the best possible care and outcomes for patients.

What it is, and isn't

De-implementation Science

Most improvement work is about adopting something new. De-implementation is the opposite discipline; deliberately and safely stopping a practice that’s already routine but doesn’t help – “unlearning” instead of learning. It’s a smaller, newer field of study, but it’s the mechanism behind every Choosing Wisely result.