De-implementing low-value care in emergency medicine: A framework for sustainable improvement

The continued use of low-value care interventions is a persisting challenge across the healthcare system despite targeted international efforts to reduce their use. These practices result in considerable economic and carbon costs. We present a model used to successfully de-implement four low-value care practices in a tertiary ED in Victoria, Australia. We outline the interventions and the proportions by which they were reduced. We provide a step-by-step framework that provides a model for other hospital departments or primary care centres to initiate their own de-implementation process for low-value care practices within their setting.