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A new study from the University of Michigan and Brigham and Women’s Hospital demonstrates a safe and effective approach to reducing unnecessary preoperative tests, potentially saving money, time, and resources.
For many patients preparing for surgery, preoperative testing—such as blood work and heart rhythm checks—is standard procedure. However, not all patients require these tests, particularly when the results have no bearing on surgical outcomes or medical decisions. A recent study published in JAMA Surgery reveals how hospitals can focus preoperative testing on those who truly need it, while eliminating unnecessary exams for others.
Study Highlights
The study, conducted at U-M Health, targeted four common tests often performed before outpatient procedures such as hernia repairs, gallbladder removals, and breast lump excisions. Prior to the study, 37% of patients received at least one unnecessary test. By the study’s conclusion, that number dropped to 14%, while overall testing rates fell from 51% to 27%.
Notably, the reduction in testing did not compromise patient safety. Rates of post-surgical emergency visits and hospitalizations remained stable, suggesting that unnecessary preoperative testing could be safely minimized.
Implementing Change
The research team, led by Dr. Lesly Dossett, M.D., M.P.H., implemented an education-based intervention that guided clinicians on best practices for reducing unneeded tests. Clinicians were provided with decision-support tools, such as flow charts, to determine which tests were essential based on patient health status and surgical risk.
“If we truly want to reduce wasteful testing—the kind that provides no value and won’t change care—we need to help team members understand the rationale,” said Dr. Dossett. “We’re excited by what we achieved at our pre-op clinics and look forward to testing this statewide.”
The study included 1,143 patients with an average age of 58 who underwent outpatient procedures at three U-M Health preoperative clinics between June 2022 and August 2023.
Statewide Expansion
Following the study’s success, U-M Health has partnered with 16 hospitals across Michigan to replicate the intervention. This expanded study aims to determine whether the approach is applicable across different healthcare settings and will also analyze the financial benefits of eliminating unnecessary tests.
The research was conducted through the Michigan Program on Value Enhancement (MPrOVE), which integrates clinical quality improvement with rigorous healthcare policy research. The study’s lead author, Dr. Alexis Antunez, M.D., M.S., emphasized the role of collaboration in achieving lasting change.
Looking Ahead
With unnecessary testing reduced at U-M Health and a larger statewide study underway, this initiative has the potential to reshape how hospitals approach preoperative evaluations. By focusing on patient-specific needs rather than routine testing, healthcare providers can improve efficiency without compromising safety.
Disclaimer
This article is based on a research study and does not constitute medical advice. Patients should consult their healthcare providers before making any decisions regarding preoperative testing.
