De-Implementation of Low-value Testing in Patients Undergoing Low-Risk Surgery
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Active de-Implementation.
- Who it may be relevant to
- Registry conditions: Breast Lumpectomy, Laparoscopic Cholecystectomy, Inguinal Hernia Repair. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Overview
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.
Interventions
- Behavioral Active 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.
Primary outcome measures
- Number of tests within 30 days of surgery not associated with an emergency department visit [Time frame: Within 30 days of surgery]
Secondary outcome measures (5)
- Number of unnecessary preoperative testing before low-risk surgery at MVC/MSQC sites not participating in the trial [Time frame: Up to year 2, quarter 4]
- 30-day episode-based spending [Time frame: Up to Year 2, Quarter 2]
- Number of unnecessary preoperative testing before low-risk surgery at trial sites [Time frame: Up to year 2, quarter 4]
- Number of intraoperative complications [Time frame: Up to year 2, quarter 4]
- Number of same-day case cancellations [Time frame: Up to year 2, quarter 4]
Eligibility criteria
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.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Sequential
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
United States · 1 center
- University of Michigan and other Michigan Surgical Quality Collaborative sites — Ann Arbor
Identifiers
NCT: NCT06934564 · HUM00261786 · R01HS029306