A customized, team-based strategy significantly reduced unnecessary pre-operative testing for common elective surgeries, according to a new study led by researchers at Ann Arbor-based Michigan Medicine.
The intervention, called Right-Sizing Testing Before Elective Surgery, or RITE-Size, was piloted at three hospitals. It focused on reducing low-value testing for patients undergoing gallbladder removal, hernia repair or breast lump removal, which are considered low-risk procedures for healthy individuals.
At the start of the study, 68% of healthy patients received at least one unnecessary test — such as an electrocardiogram or a basic metabolic panel — before surgery. After six months of implementing RITE-Size, that rate dropped to 40%. One hospital nearly eliminated unnecessary testing altogether.
The initiative involved pre-operative nurses and surgical team leaders collaborating to assess the use of 11 routine tests. The program offered education, coaching, regular data reports and other resources tailored to each hospital’s needs.
“Our results show the importance of understanding what factors influence testing decisions at each hospital, and tailoring a multidimensional intervention to that environment,” Lesly Dossett, MD, senior author of the study, surgeon and healthcare researcher at U-M Health, said in a news release.
Based on the results, the program is now being expanded to 16 more hospitals across the state.