Implementation Pilot of Preoperative CGA Referral Process for Older Patients Undergoing Major Surgery
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 1,530
- 试验地点
- 1
- 主要终点
- Number of patients referred divided by number of eligible patients
研究概览
简要总结
The goal of this clinical trial is to test whether a new implementation package can help older adults prepare for major surgery. The main question it aims to answer is: Can the implementation package help give more people access to this resource? Participants will be in two groups: older adults who are planning a major surgery and their medical and surgical healthcare providers. The results will be compared to a historic baseline.
详细描述
The goal of this clinical trial is to test a new implementation package, which will be applied at the system-level, to see whether it can help more older adults prepare for major surgery. The study will evaluate whether the implementation package (1) improves the number of older adults who get a full "comprehensive geriatric assessment" (CGA) before surgery compared to the number of older adults who would be eligible for it, also called "reach"; and (2) increases the use of CGA by the medical and surgical providers who are taking care of these older adults, also called "adoption".
Participants will be in two groups: older adults who are planning a major surgery and their medical and surgical healthcare providers. The implementation package will include streamlined referral processes and education for surgeons and staff about the new processes. The results will be compared to a historic baseline
Findings from this study will help the lead researcher design a larger trial that will test both the implementation (or how something is done) at the same time as it tests the effectiveness (how well it works).
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patient aged 80 or older who is scheduled for an elective inpatient major surgery
- •Providers working in a clinic (aged 18 and older) where pCGA is performed or a related anesthesia pre-operative clinic
- •Surgeons (adults older than 18) with a patient aged 80 or older who is scheduled for an elective inpatient major surgery
排除标准
- 未提供
研究组 & 干预措施
Post Implementation
Participants will be recruited from surgery clinics in the post-implementation group. They will go through a streamlined referral process as part of an implementation package for CGA before surgery.
The control group will be historic baseline data. That is, older surgical patients who were treated Pre-Implementation. These patients would have received standard, routine clinical care without the use of the implementation package.
干预措施: Implementation Package for CGA (Other)
Post Implementation
Participants will be recruited from surgery clinics in the post-implementation group. They will go through a streamlined referral process as part of an implementation package for CGA before surgery.
The control group will be historic baseline data. That is, older surgical patients who were treated Pre-Implementation. These patients would have received standard, routine clinical care without the use of the implementation package.
干预措施: Routine Clinical Care (Other)
结局指标
主要结局
Number of patients referred divided by number of eligible patients
时间窗: 6 and 12 months after implementation
Reach to potentially eligible patients will be measured by the number of patients referred divided by number of eligible patients.
Number of surgeons placing referral orders divided by the number of surgeons
时间窗: 6 and 12 months
Adoption by Referring Surgeons will be measured by the number of surgeons placing referral orders divided by the number of surgeons
次要结局
- Acceptability of Intervention Measure (AIM) Score(6 and 12 months)
- Fidelity: Percent of completed CGA components per visit(30 days after visit)
- Feasibility of Intervention Measure (FIM) Score(6 and 12 months)
- Intervention Appropriateness Measure (IAM) Score(6 and 12 months)