Study Shows How to Reduce Them Safely

For Many Patients, Getting Ready to Have Surgery Means Getting Their Blood Drawn, Their Heart Rhythm Checked, Or Having Other Tests in the Weeks Leading Up To Their Operation.

Butt Not All Patients Need All Those Tests—Specially If the Results Won’t Change How Their Surgical Team Treats Them Or How Well They from Afterward.

Now, the New Study Shows How Hospital Hospitals Can Focus The Use of Such Tests on the Patients Who Trula Need Them, While Safely Reducing Unnecessary Testing In other.

The Result: Less Wasted Money and Resources for Each Test, and Less Wasted Time for Patients and Clinical Staff.

The Study, published in JAMA SURGEY By a Team from the University of Michigan and Brigham and Women’s Hospital, TESTED A PROGRAM Designed to Reduce Unneeded Preoperative Tests at a Health.

It focused on Reducing Four tests in low-risk Patients Having Breast Lumps or Diseased Gallbladers Removed, or Hernas Fixed, In Outpatient Operations.

Before The Intervention, 37% of Such Patients Had at Least One Unnecessary Test. By the end of the Study, that rate dropped to 14%. Overall Testing – The Percentage of All Poients Receue the Four Tests Before Having these Operations – Dropped from 51% to 27%.

At the Same Time, Preoperative Testing Didn’t Change for Patients Who Needed It, Based on Their Health Status and Surgical Risk. Rates of Emergency Department Visits and Hospitalizations Stayed the Same in the Weeks After Patients Had Their Operations, Suggesting That Reducing Unnecessary Testing Didn’t Worsen Surgical Safety or Outcomes.

The New Study Shows That During the Time When a Health Reduced Unnecessary Testing and Overall Testing, The Use of the Same Tests in Similar Patients Stayed the Same at Dozens of other hospitals in the state.

Making Change Together, and Measuring Its Effect

The Study’s Leader says it’s not just the drop in unnecessary testing, but the Team the Team Achieved it and measred it that makes the Study Different.

The Intervention Focused on Educating Clinicians on the evidence that Could Safely Reduce Testing in Some Patients, and Involving Them in How they did so, says Senior Author and a Health Surgeon Lesly Dossett, MD, MPH

“IF We TRULY WANT TO REDUCE WASTEFUL TESTING, THE KIND THAT PROVIDES IN VALUE AND WON’T CHANGE CARE, WE NEED TO HELP TEAM MEATS UNERSTAND THE RATIONAL, TO BASE OUR INTERVENTION ON WHAT WE KNOW ABOUT CREATING POSITIVE CHANGE, AND TO PRODUCT EASY-TO-USE TOOLS TO SUPPORT CLINICAL DECISIONS, “Said Dossett. “We’re excited by What We Were Able to Achieve at OUR PRE-OP Clinics, and Look Forward to Testing This in Hospital Hospital Statewide.”

Dossett Co-Leads The Michigan Program on Value Enhancement, Or Mprove, Through Which The New Study Was Drive. MPROVE TEAMS The Clinical Quality Improvement Efforts of a Health with the Rigous Research Methods of the Institute for Healthcare Policy and Innovation.

The Study Involved 1,143 Patients with an averag Age of 58 Seen at a Health’s Three Pre-Op Clinics for Outpatient Surgery Sites from June 2022 to the end of August 2023.

A Health Had High Levels of Pre-Op Testing (Both necessary and unnecessary) In A PREVIOUS STUDY OF 63 HOSPLY ACROSS MICHIGAN PUBLISHED IN 2021, SO IT WAS A KEY AREA FOR INDEALING.

During the Intervention Period, The Surgeons and Physician Assistants Involved in the Pre-Op Clinics Had Multiple Sessions with the Study Team, and Worked to Build Consensus Around Which Patients Needed Which Tests and Which Did Not.

In the End, The Clinicians were asked to follow the flow chart and grid—Called Decision Support Documents—The determine whic tests A Patient Should Have Before Surgery, Based on Their Individual Characteristics.

The Tests in question were selected BECAUSE Years of Research and Recommendations from National and International Health Care Quality Groups have Deemed Them Unnecessary for Right Patients. Blood tests Called Complete Blood Cell Counts (CBCs), Basic Metabolic Panels (BMPS) and Comprahensive Metabolic Panels (CMPS) Were Targeted, the Were Electrocardiograms.

EACH PATENT WAS SCORED ON STANDARD SCALE USED BY ANESThesia Professionals to Rate the Risk Of A Patient Suffering The Complication During Anesthesia. Those on the lowest Two Rungs Were Able to Forego All Four Tests Unless A Specialist Had Specifically Ordried it. But Even Patients at the Higher End of This Scale, Called the Asa Physical Status, Were Able to Avoid Right Tests Depending on What other conditions they have.

Alexis Antunez, MD, MS, is to a medical school alumna and the Study’s First Author. She was visiting Surgical Resident Resident at Michigan Medicine at the Time of the Study and Is Now at the Brigham and Women’s Department of Surgery.

MPROVE PROGRAM MANAGER TONY CUTTITTA, MPH, NOTES THAT SEVERAL A MEDICAL STUDENTS WORKED ON THE STUDY DATE ANALYSIS. He also explains that the one Team is Working to Scale Up the Number of Surgical Specialties Using the Approach and Evaluate The Impacts.

The Effort was so succcessful that the one Team is partnering with 16 other hospitals Across Michigan to Repeat the Same Intervention That Spurred the Change.

The Statewide Study is Now Underway. IT INVOLVES HOSPLOS TAKING PART IN COLBRABATIVE QUALITY INITIATIVES AND WILL TEST WHETHER THE MODEL THAT SUCCEDED AT A HEALTH IS GENERALIZABLE TO OHER CARE SETTINGS. IT Will Also Analyze The Financial Impact of Avoiding Unnecessary Tests.

In Addition to Dossett, Antunez and Cuttita, The Study’s Authors Are Ruby J. Kazemi, BA; Caroline Richburg, MD; Cecilia Pesavento, MD, MBA; ANDrew VASTARDIS, MS; ERIN KIM, BS; ABIGAL L. KAPPELMAN, MA; DEVAK NANUA, MS; Hiba Pediyakkal, BA; FAELAN JACOBSON-DAVIES, MA; Shawna N. Smith, Ph.D.; James Henderson, Ph.D., 10; Valerie Gavrila, MPH; and Hari Nathan, MD, Ph.D.