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Defining and conceptualizing outcomes for de-implementation: key distinctions from implementation outcomes.
Beth Prusaczyk1, Taren Swindle2, Geoffrey Curran2,3
1Washington University School of Medicine in St. Louis, 660 S. Euclid Avenue, St. Louis, MO 63110 USA.
De-implementation outcomes are distinct from implementation outcomes. This study conceptualizes de-implementation outcomes, offering guidance for measuring them in various settings.
Area of Science:
- Health Services Research
- Implementation Science
- Healthcare Management
Background:
- Scholars increasingly distinguish de-implementation from implementation, recognizing unique factors for stopping practices.
- De-implementation outcomes represent a key area of distinction, differing from or overlapping with implementation outcomes.
- Understanding de-implementation outcomes is crucial for optimizing healthcare practices and resource allocation.
Purpose of the Study:
- To conceptualize de-implementation outcomes using existing implementation outcome frameworks.
- To provide guidance on measuring de-implementation outcomes in diverse settings like clinical care and community programs.
- To highlight considerations for assessing de-implementation, including patient drivers of overuse and practice significance.
Main Methods:
- Conceptualizing de-implementation outcomes based on Proctor and colleagues' taxonomy.
- Identifying key considerations for researchers assessing de-implementation outcomes.
- Illustrating concepts with examples from clinical and community settings.
Main Results:
- De-implementation outcomes can be conceptualized by adapting implementation outcome taxonomies.
- Measurement considerations include the targeted practice, the de-implementation process, and outcome thresholds.
- Factors like health disparities, cultural relevance, and altruism influence outcome assessment.
Conclusions:
- Existing implementation outcomes were conceptualized within the de-implementation context, highlighting similarities and differences.
- A clear distinction between the de-implementation target and strategies is recommended.
- This analysis serves as a foundation for future de-implementation research and practice.
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