Multicomponent Deimplementation Strategy to Reduce Low-Value Preoperative Testing
Authors' conclusion
In this quality improvement study, a multicomponent deimplementation strategy was associated with a reduction in unnecessary preoperative testing before low-risk general surgery operations.
Study context
- Population
- Adults undergoing nonurgent outpatient inguinal hernia repair, lumpectomy or laparoscopic cholecystectomy at a single academic quaternary referral hospital, June 2022–August 2023
- Participants
- 1,143 adults
- Comparison
- Preintervention vs Intervention vs Postintervention
- Preinterventionn = 261reference
- Interventionn = 510
- Postinterventionn = 372
- Outcome
- Rate of unnecessary preoperative tests across each period
Methodological detailspre-post interventional design, interrupted time series, difference-in-difference analysis, single-centre
- Pre-post interventional design
- Interrupted time series
- Difference-in-difference analysis
- Single-centre
Main finding
As reported in the abstract
Unnecessary preoperative testing rate
Testing rate change
−16%
95% CI −4% to −27%; P = 0.01
Intervention
Testing rate change
−27%
95% CI −17% to −38%; P = 0.003
Postintervention
Further findings
Overall testing at other hospitals in the state (difference-in-difference)
- Decrease in overall testing not observed at other hospitals on adjusted difference-in-difference analysis
Original publication
Multicomponent Deimplementation Strategy to Reduce Low-Value Preoperative Testing. JAMA Surg. Published 1 March 2025. doi:10.
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