Development and Implementation of Preoperative Optimization for High-Risk Patients With Abdominal Wall Hernia

Key Points Question Is a stepwise implementation intervention associated with increased use of preoperative optimization by surgeons for patients with abdominal wall hernia? Findings In this quality improvement study including 23 000 patients, preoperative optimization for high-risk patients with abdominal wall hernia varied from 20% to 53% across 73 hospitals owing to barriers that included lack of surgeon knowledge and financial concerns. An intervention involving on-site education and financial incentivization increased referral for preoperative optimization by 860%. Meaning Implementation strategies that address real-world barriers may be an effective method to increase surgeon use of evidence-based practice.