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

University of Michigan

Status: Enrolling

Conditions: Inguinal Hernia Repair; Laparoscopic Cholecystectomy; Breast Lumpectomy

Treatments: Behavioral: Active de-Implementation

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT06934564

R01HS029306 (U.S. AHRQ Grant/Contract)

HUM00261786

Details and patient eligibility

About

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.

Enrollment: 16 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion 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.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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16 participants in 6 patient groups

Wave 1

Experimental group

Description:

Each wave will include usual care, preparation (8 weeks before intervention), active de-implementation interventions, and sustainment phases. Intervention is Year 1 Quarter 2

Treatment:

Behavioral: Active de-Implementation

Wave 2

Experimental group

Description:

Each wave will include usual care, preparation (8 weeks before intervention), active de-implementation interventions, and sustainment phases. Intervention is Year 1 Quarter 3

Treatment:

Behavioral: Active de-Implementation

Wave 3

Experimental group

Description:

Each wave will include usual care, preparation (8 weeks before intervention), active de-implementation interventions, and sustainment phases. Intervention is Year 1 Quarter 4

Treatment:

Behavioral: Active de-Implementation

Wave 4

Experimental group

Description:

Each wave will include usual care, preparation (8 weeks before intervention), active de-implementation interventions, and sustainment phases. Intervention is Year 2 Quarter 1

Treatment:

Behavioral: Active de-Implementation

Wave 5

Experimental group

Description:

Each wave will include usual care, preparation (8 weeks before intervention), active de-implementation interventions, and sustainment phases. Intervention is Year 2 Quarter 2

Treatment:

Behavioral: Active de-Implementation

Wave 6

Experimental group

Description:

Each wave will include usual care, preparation (8 weeks before intervention), active de-implementation interventions, and sustainment phases. Intervention is Year 2 Quarter 3

Treatment:

Behavioral: Active de-Implementation