Enhancing Surgical Efficiency: How Tailored Strategies and Team Collaboration Reduce Unnecessary Preoperative Tests

Every day, patients preparing for surgery often undergo a series of blood tests, heart assessments, and imaging scans. However, recent research highlights that in many cases, these tests do not influence the surgical plan, leading to unnecessary procedures that add time, stress, and costs to patient care.

A groundbreaking study led by the University of Michigan has demonstrated effective methods to minimize such wasteful preoperative testing without compromising patient safety or surgical outcomes. The study focused on three hospitals and initially found that 68% of healthy patients undergoing elective surgeries like gallbladder removal, hernia repair, or breast lump excision were subjected to unnecessary tests. Through targeted educational and supportive interventions tailored to each hospital’s environment, the hospitals reduced this rate to approximately 40% within six months. Remarkably, one hospital nearly eliminated wasteful testing entirely.

The research team implemented a comprehensive, multi-layered approach called Right-Sizing Testing Before Elective Surgery (RITE-Size). This involved analyzing current testing practices, engaging surgical and preoperative teams, providing continuous education, coaching, and detailed data feedback to facilitate informed decision-making. Importantly, the inclusion of nurses in the implementation process was identified as a critical factor in the program’s success, recognizing their vital role within the healthcare team.

The positive outcomes from this pilot program prompted expansion to 16 additional Michigan hospitals, involving collaborative efforts like the Michigan Value Collaborative, the Michigan Surgical Quality Collaborative, and the Multicenter Perioperative Outcomes Group. The overarching goal is to sustain and further enhance the efficiency of preoperative testing, thereby saving resources, reducing patient inconvenience, and streamlining surgical workflows.

This innovative approach emphasizes understanding hospital-specific factors influencing test ordering and underscores the importance of teamwork, education, and data-driven strategies in healthcare quality improvement. As these practices spread, they promise to set new standards for responsible, patient-centered surgical care.