Evolve Recommendations on Low Value Care

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

As part of a global movement, Evolve is a flagship initiative led by physicians and the Royal Australasian College of Physicians (RACP) to drive high-value, high-quality care in Australia and New Zealand.

Reducing low-value care

Evolve works with specialties to identify their ‘Top-Five’ clinical practices that, in particular circumstances, may:

  • be overused,
  • provide little or no benefit, or
  • cause unnecessary harm.


Physician led movement

Evolve aims to reduce low-value care by supporting physicians to:

  • be leaders in changing clinical behaviour for better patient care
  • make better decisions, and
  • make better use of resources.

Choosing Wisely

RACP is a founding member of Choosing Wisely in Australia and New Zealand. All Evolve recommendations are made available through Choosing Wisely. By bringing together recommendations from multiple medical colleges and healthcare organisations, 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?


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

  • Order Evolve merchandise and collateral for your next event to share the word.
  • Follow us on Twitter, Facebook, Instagram and LinkedIn.
  • Join the Evolve Policy Reference Group and help shape and drive the Evolve initiative (email evolve@racp.edu.au to join).
  • Be a part of developing your Specialties Top 5 Recommendations.
  • Make recommendations a routine part of clinical handovers.
  • Include recommendations in education sessions like grand rounds, workshops, clinical case reviews, team meetings and more.
  • Undertake a clinical audit and feedback project on a recommendation.
  • Build your skills to enable them to participate in joint decision making with their patients, or have difficult discussions with their colleagues or supervisor.
  • Engage hospital management in implementing the recommendations across the health service.
  • Discuss the recommendations with referring doctors and your multidisciplinary care team.
  • Encourage organisational and department Evolve Champions to help drive change.
  • Undertake research on Evolve and implementation of Evolve recommendations
  • Share your experiences, ideas and challenges with us and other physicians.

Don’t forget you may be able to claim some of your Evolve activities as CPD. Check against the MyCPD Framework.