Evolve
Better care. Better decision-making. Better use of resources. 


Part of a global movement, Evolve is an initiative led by physicians and the Royal Australasian College of Physicians (RACP) to drive high-value, high-quality care in Australia and New Zealand. The Evolve initiative identifies a specialty's Top 5 clinical practices that, in particular circumstances, may be overused, provide little or no benefit or cause unnecessary harm. Developing and implementing strategies to support physicians, the Evolve initiative aims to change clinical behaviour, decision-making and reduce low-value care. ​RACP is a founding member of Choosing Wisely in Australia and New Zealand. 

Choosing Wisely

RACP is a founding member of Choosing Wisely in Australia and New Zealand. All Evolve recommendations are made available ​through these campaigns. By bringing together recommendations from multiple medical colleges and healthcare organisations, together with expertise in consumer and patient care, Choosing Wisely helps healthcare providers and consumers start important conversations about improving the quality of healthcare. 

Call to Action

The RACP ​encourages physicians to implement these recommendations in their work and health services. Evolve encourages physicians reflect and consider why a clinical practice will not be of benefit to a patient by asking:
  • Are these low-value practices that I do? 
  • Are these low-value practices that I see happening?​
  • Are there systems, processes or expectations that encourage or drive these low-value practices in my health service​? 

Considering the Individual Patient

Evolve encourages physicians to engage in shared decision-making with a patient and/or carer. In partnership with Choosing Wisely Australia's '5 questions to ask your doctor', Evolve asks physicians to ask these 'Top 5 questions before making a clinical decision': 

  1. Should I undertake this practice for this patient?
  2. Do the risks to the patient outweigh the benefits?
  3. Does the patient really need this test, treatment or procedure?
  4. Are there simpler, safer options?​
  5. Does this Evolve recommendation make a difference to my clinical decision-making?

Implementation

Evolve encourages physicians to include the recommendations in routine clinical care, for example:

  • Clinical handovers (e.g. between health services, between clinicians) 
  • Clinical audits and feedback 
  • Computer decision support systems, (e.g. electronic ordering, prescribing systems) 
  • Education sessions (e.g. grand rounds, clinical case reviews, teachable moments) 
  • Nominate Evolve Clinical Champions in health services or specialties
  • Engage hospital management/executive with Evolve initiatives