Unpacking the complexities of de-implementing inappropriate health interventions

被引:211
作者
Norton, Wynne E. [1 ]
Chambers, David A. [1 ]
机构
[1] Natl Canc Inst, Div Canc Control & Populat Sci, 9609 Med Ctr Dr,3E424, Bethesda, MD 20850 USA
关键词
De-implementation; Ineffective; Low-value; Unproven; Harmful; De-adoption; De-escalation; Overtreatment; Overscreening; Overuse; Implementation science; Medical reversal; NATURAL EXPERIMENTS; DEFENSIVE MEDICINE; PHYSICIANS; FRAMEWORK;
D O I
10.1186/s13012-019-0960-9
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
De-implementing inappropriate health interventions is essential for minimizing patient harm, maximizing efficient use of resources, and improving population health. Research on de-implementation has expanded in recent years as it cuts across types of interventions, patient populations, health conditions, and delivery settings. This commentary explores unique aspects of de-implementing inappropriate interventions that differentiate it from implementing evidence-based interventions, including multi-level factors, types of action, strategies for de-implementation, outcomes, and unintended negative consequences. We highlight opportunities to continue to advance research on the de-implementation of inappropriate interventions in health care and public health.
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页数:7
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