De-Implementation of Low-value Testing in Patients Undergoing Low-Risk Surgery
University of Michigan
Summary
This trial aims to evaluate the effectiveness of a multi-level, multi-component de-implementation strategy to reduce unnecessary preoperative testing. Sixteen Michigan Value Collaborative (MVC)/Michigan Surgical Quality Collaborative (MSQC) sites in Michigan will implement several tools that have been proven to reduce unnecessary testing at a single site, including clinician education, a decision aid, audit and feedback on performance, and a pay-for-performance incentive. The researchers believe that, through the use of these strategies, there will be a significant reduction in unnecessary preoperative testing during the intervention.
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Site Inclusion Criteria: * Over 30% of testing rates on at least one of the three index procedures (breast lumpectomy, laparoscopic cholecystectomy, and inguinal hernia repair) Exclusion Criteria: * none Surgical participants must be over 18 years old.
Interventions
- BehavioralActive de-Implementation
During active de-implementation (3 months), the local team will distribute the strategy components (i.e., clinician education, decision support, evaluation, consensus building around perioperative testing pathways, facility-specific feedback, and a pay-for-performance incentive) at the local site.
Location
- University of Michigan and other Michigan Surgical Quality Collaborative sitesAnn Arbor, Michigan