Over-utilization of tests, treatments, and procedures is an important example of low value care that adds to the high cost of healthcare, and provides little to no benefit for patients. To combat this problem, the American Board of Internal Medicine Foundation developed the Choosing Wisely Campaign, tasking professional societies to develop lists of the top five medical services that patients should question. The Critical Care Societies Collaborative (CCSC), which is comprised of the four major U.S. professional and scientific societies including: the American Association of Critical-Care Nurses (AACN), the American College of Chest Physicians (CHEST), the American Thoracic Society (ATS), and the Society of Critical Care Medicine (SCCM) participated by creating a taskforce that addressed this task to focus on critical care delivery.

Five CCSC recommendations were formulated:

1. Don't order diagnostic tests at regular intervals (such as every day), but rather in response to specific clinical questions.
2. Don't transfuse red blood cells in hemodynamically stable, non-bleeding patients with a hemoglobin concentration greater than 7 mg/dL.
3. Don't use parenteral nutrition in adequately nourished critically ill patients within the first seven days of an ICU stay.
4. Don't deeply sedate mechanically ventilated patients without a specific indication and without daily attempts to lighten sedation.
5. Don't continue life support for patients at high risk for death or severely impaired functional recovery without offering patients and their families the alternative of care focused entirely on comfort.

The CCSC is tracking use/ implementation of the Choosing Wisely recommendations among its four member organizations.

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