De-implementation of Unnecessary Pre-Operative Urine Testing
VA Office of Research and Development
Summary
This is a randomized study to evaluate the effectiveness and implementation of an intervention to decrease unnecessary urine testing for surgical patients (Less is More for Surgical Urine Testing) across six geographically diverse Veterans Affairs Medical Centers. The intervention will unfold over two years, in three phases: control, intervention, and sustainability.
Description
The purpose of this study is to implement our surgery-tailored evidence based 'Kicking CAUTI' intervention package in diverse surgical settings across the Veterans Affairs Medical Centers (VAMCs), and assess its effectiveness at de-implementing low-value perioperative urine testing and related inappropriate antibiotic prescribing. In this hybrid type 2 effectiveness-implementation study, the investigators will conduct a stepped wedge cluster randomized trial to evaluate the effectiveness, implementation, and cost of the tailored intervention at up to six VAMCs.
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Medical Centers part of the Veterans Affairs Health Administration (VAMCs) * VAMCs that perform standard, intermediate, or advanced surgical procedures * VAMCs in which perioperative urine testing is performed among greater than 10% of their non-urologic, non-transplant surgery procedures Exclusion Criteria: * VAMCs that only perform ambulatory surgery (outpatient/day surgery only) * VAMCs that do not perform urine testing among at least 10% of their non-urologic, non-transplant surgery procedures * VAMCs that already have implemented interventions to reduce perioperat…
Interventions
- BehavioralInterventional Project Site Visit
Activities occurring during the 12-month intervention phase * 1:1 meetings introducing the project * Site Visit (once during intervention period) * Interactive teaching cases and didactic sessions * Distribution of algorithm as pocket cards * Access to project materials on SharePoint * Feedback reports on clinical outcomes * Evidence-based order set templates * Learning collaborative webinars * Individualized coaching
Location
- William S. Middleton Memorial Veterans Hospital, Madison, WIMadison, Wisconsin