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Management strategies to de-implement low-value care-an applied behavior analysis
Sara Ingvarsson1, Henna Hasson2,3, Hanna Augustsson2,3
1Procome Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, SE, Sweden. sara.ingvarsson@ki.se.
Implementation Science Communications
|June 25, 2022
Summary
Understanding management strategies to de-implement low-value care (LVC) is crucial. Both regional and local healthcare center strategies, analyzed using applied behavior analysis, effectively influence physician behavior to reduce LVC.
Area of Science:
- Healthcare Management
- Behavioral Science
- Health Services Research
Background:
- Limited understanding exists regarding management strategies for de-implementing low-value care (LVC).
- The mechanisms through which these strategies influence physician behavior remain unclear in current literature.
- Applied behavior analysis (ABA) offers a framework to understand behavioral change processes relevant to de-implementation.
Purpose of the Study:
- To identify management strategies used for de-implementing LVC.
- To explore the mechanisms involved in these strategies using ABA concepts.
- To understand how strategies can modify physicians' LVC-related behaviors.
Main Methods:
- Qualitative study design with an inductive approach to identify strategies.
- Deductive analysis of strategy mechanisms using applied behavior analysis (ABA) concepts.
Main Results:
- Eight distinct management strategies for influencing LVC were identified.
- Five strategies originated at the regional level, influencing LVC through rules or initiating local actions.
- Local strategies within healthcare centers demonstrated a stronger potential for influencing de-implementation of LVC.
Conclusions:
- Effective de-implementation of LVC requires consideration of both systemic (regional) and local (healthcare center) strategies.
- Local strategies offer unique advantages for impacting LVC due to their adaptability to specific circumstances.
- Applied behavior analysis (ABA) can aid in tailoring strategies to effectively reduce LVC utilization.
Keywords:
Applied behavior analysisDe-implementationLow-value carePhysiciansPrimary health careRule-governed behaviorSwedenThree-term contingencyMore Related Videos
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