Reducing unnecessary preoperative tests for low risk surgeries
Does a Theory-Based Intervention to Improve Accountability Reduce Low-Value Preoperative Investigations in Patients Undergoing Low Risk Surgery?
This study is trying to see if a new approach can help doctors order fewer unnecessary tests before low-risk surgeries to make care better and more efficient for patients.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 22 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Ottawa Hospital Research Institute Academic / other |
| Locations | 4 sites (Muskoka, Onario and 3 other locations) |
| Trial ID | NCT05526495 on ClinicalTrials.gov |
What this trial studies
This study evaluates the effectiveness of a multi-component behavioral intervention aimed at anesthesiologists and surgeons to reduce the ordering of low-value preoperative tests, such as electrocardiograms and chest X-rays, in patients undergoing low-risk surgeries. The intervention is based on the Choosing Wisely De-Implementation Framework and seeks to change behaviors and decisions among healthcare providers in Ontario, Canada. The study will assess the overall rate of these low-value tests, along with economic and process evaluations, across 22 hospitals. By addressing low-value care, the study aims to improve patient outcomes and healthcare efficiency.
Who should consider this trial
Good fit: Ideal candidates for this study are adults aged 18 and older who are scheduled for low-risk surgeries such as endoscopy, ophthalmologic surgery, knee arthroscopy, or hernia repair.
Not a fit: Patients undergoing emergency elective procedures or those requiring chest X-rays and electrocardiograms for urgent reasons may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could lead to a significant reduction in unnecessary preoperative testing, improving patient safety and reducing healthcare costs.
How similar studies have performed: Other studies have shown success in reducing low-value care through behavioral interventions, making this approach promising yet still innovative in its application.
Eligibility criteria
Show full inclusion / exclusion criteria
The study intervention will target hospitals, anesthesiologists, surgeons, pre-admission clinic nurses, and administrative staff. Cluster (Hospital) Level Inclusion Criterion: 1. Hospitals in Ontario, Canada 2. within the 26-100th centile for routine preoperative tests for 2019 The study will recruit anesthesiologist and surgeons taking care of patients that meet the following criterion: Patient Level Inclusion Criterion: 1. ≥18 age 2. undergoing low risk surgeries such as: * endoscopy * ophthalmologic surgery * knee arthroscopy * hernia repair Exclusion Criteria: * emergency elective chest X-rays and/or electrocardiogram
Where this trial is running
Muskoka, Onario and 3 other locations
- Muskoka Algonquin Healthcare — Muskoka, Onario, Canada (Recruiting)
- Grand River Hospital — Kitchener, Ontario, Canada (Recruiting)
- St.Joseph'S Health Care — London, Ontario, Canada (Recruiting)
- Stratford General Hospital — Stratford, Ontario, Canada (Recruiting)
Study contacts
- Principal investigator: Kyle Kirkham, MD — Department of Anaesthesia, Toronto Western Hospital, University of Toronto
- Study coordinator: Alfonso Ortiz, MSc
- Email: lortiz@ohri.ca
- Phone: 613-929-8423
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.