Implementation Pilot of Preoperative CGA Referral Process for Older Patients Undergoing Major Surgery
Overview
- Phase
- N/A
- Intervention
- Implementation Package for CGA
- Conditions
- Surgery
- Sponsor
- University of Wisconsin, Madison
- Enrollment
- 1530
- Locations
- 1
- Primary Endpoint
- Number of patients referred divided by number of eligible patients
- Status
- Recruiting
- Last Updated
- 2 months ago
Overview
Brief Summary
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.
Detailed Description
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).
Investigators
Eligibility Criteria
Inclusion Criteria
- •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
Exclusion Criteria
- Not provided
Arms & Interventions
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.
Intervention: Implementation Package for CGA
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.
Intervention: Routine Clinical Care
Outcomes
Primary Outcomes
Number of patients referred divided by number of eligible patients
Time Frame: 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
Time Frame: 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
Secondary Outcomes
- 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)