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Commentary: De-implementation Science: A Virtuous Cycle of Ceasing and Desisting Low-Value Care Before Implementing
Karina W Davidson1,2, Siqin Ye1, George A Mensah3
1Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, New York.
Ethnicity & Disease
|December 12, 2017
Summary
De-implementation science focuses on stopping low-value care, unlike traditional implementation science. This approach can reduce clinician workload and free up resources for high-quality care.
Area of Science:
- Health services research
- Implementation science
- De-implementation science
Background:
- Traditional implementation science prioritizes increasing evidence-based care delivery.
- The science of de-implementation, focusing on stopping low-value care, is under-recognized.
- De-implementation can potentially decrease clinician workload and reduce healthcare waste.
Discussion:
- De-implementation science involves identifying low-value practices.
- It rigorously examines factors maintaining these practices.
- Evidence-based interventions are then used to cease these practices.
Key Insights:
- De-implementation requires distinct health system supports.
- Economic and non-economic levers are crucial for success.
- Behavior change techniques are essential for effective de-implementation.
Outlook:
- De-implementation can create a virtuous cycle of care improvement.
- Removing low-value care makes space for high-quality care.
- This feedback loop enhances overall healthcare value and efficiency.
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