Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence

Burton, Christopher, Williams, Lynne, Bucknall, Tracey, Edwards, Stephen, Fisher, Denise, Hall, Beth, Harris, Gill, Jones, Peter, Makin, Matthew, McBride, Anne, Meacock, Rachel, Parkinson, John, Rycroft-Malone, Jo and Waring, Justin 2019, Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence, Systematic reviews, vol. 8, no. 1, pp. 1-7, doi: 10.1186/s13643-019-1111-8.

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Title Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence
Author(s) Burton, Christopher
Williams, Lynne
Bucknall, TraceyORCID iD for Bucknall, Tracey orcid.org/0000-0001-9089-3583
Edwards, Stephen
Fisher, Denise
Hall, Beth
Harris, Gill
Jones, Peter
Makin, Matthew
McBride, Anne
Meacock, Rachel
Parkinson, John
Rycroft-Malone, Jo
Waring, Justin
Journal name Systematic reviews
Volume number 8
Issue number 1
Start page 1
End page 7
Total pages 7
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2019-08-05
ISSN 2046-4053
Keyword(s) Concept analysis
De-implementation
Health services
Low-value practice
Overuse
Realist synthesis
Summary Background: Strategies to improve the effectiveness and quality of health and care have predominantly emphasised the implementation of new research and evidence into service organisation and delivery. A parallel, but less understood issue is how clinicians and service leaders stop existing practices and interventions that are no longer evidence based, where new evidence supersedes old evidence, or interventions are replaced with those that are more cost effective. The aim of this evidence synthesis is to produce meaningful programme theory and practical guidance for policy makers, managers and clinicians to understand how and why de-implementation processes and procedures can work. Methods and analysis: The synthesis will examine the attributes or characteristics that constitute the concept of de-implementation. The research team will then draw on the principles of realist inquiry to provide an explanatory account of how, in what context and for whom to explain the successful processes and impacts of de-implementation. The review will be conducted in four phases over 18 months. Phase 1: develop a framework to map the preliminary programme theories through an initial scoping of the literature and consultation with key stakeholders. Phase 2: systematic searches of the evidence to develop the theories identified in phase 1. Phase 3: validation and refinement of programme theories through stakeholder interviews. Phase 4: formulating actionable recommendations for managers, commissioners and service leaders about what works through different approaches to de-implementation. Discussion: This evidence synthesis will address gaps in knowledge about de-implementation across health and care services and ensure that guidance about strategies and approaches accounts for contextual factors, which may be operating at different organisational and decision-making levels. Through the development of the programme theory, which explains what works, how and under which circumstances, findings from the evidence synthesis will support managers and service leaders to make measured decisions about de-implementation.
Language eng
DOI 10.1186/s13643-019-1111-8
Indigenous content off
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2019, The Author(s)
Persistent URL http://hdl.handle.net/10536/DRO/DU:30128959

Document type: Journal Article
Collections: Faculty of Health
School of Nursing and Midwifery
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