A multi-disciplinary intervention will reduce inappropriate preoperative testing for cataract surgery. Despite multiple rigorous randomized controlled trials and meta-analyses showing that pre-operative testing for cataract surgery does not improve outcomes, pre-operative testing has not declined. A quality improvement initiative, which includes gaining senior leadership support, changing the culture of care, and elimination of pre-operative consultation visits for cataract surgery, to reduce inappropriate pre-operative testing. Quasi-experimental difference-in-difference analysis comparing the intervention arm (LAC+USC Medical Center) with the control arm (Harbor-UCLA Medical Center), 6 months prior and 6 months after the intervention. Generalized estimating equation models will adjust for age, gender, race/ethnicity, comorbidities and cluster by site.
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Inappropriate pre-operative testing (Clinical Labs)
Timeframe: 1 year: 6 months prior to guideline implantation & 6 month after guideline implementation
Inappropriate pre-operative testing (EKG)
Timeframe: 1 year: 6 months prior to guideline implantation & 6 month after guideline implementation
Inappropriate pre-operative testing (Chest X-rays)
Timeframe: 1 year: 6 months prior to guideline implantation & 6 month after guideline implementation
Inappropriate pre-operative testing (Provider Visits)
Timeframe: 1 year: 6 months prior to guideline implantation & 6 month after guideline implementation