Reducing Unnecessary Preoperative Tests for Patients Having Low-Risk Surgeries Using Education and Incentives at Michigan Surgical Sites

What this Trial Is About

The trial focuses on patients undergoing low-risk surgeries such as breast lumpectomy, laparoscopic cholecystectomy, and inguinal hernia repair. It aims to evaluate how well a multi-level, multi-component strategy reduces unnecessary preoperative testing. This research is sponsored by the University of Michigan and involves multiple surgical quality collaborative sites in Michigan to improve care practices. The study uses an active de-implementation approach involving clinician education, decision aids, performance feedback, and pay-for-performance incentives. These interventions are delivered locally over a three-month active phase following an eight-week preparation, across six waves starting in 2025 and continuing through 2026. Each wave includes periods of usual care, preparation, intervention, and sustainment to assess the impact of these strategies. Participants will be involved through their surgical care at participating sites, with the study monitoring the number of unnecessary tests done within 30 days before surgery. The research also tracks spending related to episodes of care, intraoperative complications, and same-day surgery cancellations. Data will be collected during and after the intervention phases to measure the effectiveness of reducing low-value testing and improving surgical outcomes over the study period.

De-Implementation of Low-value Testing in Patients Undergoing Low-Risk Surgery