Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence
Abstract 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 p...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | Systematic Reviews |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13643-019-1111-8 |
| _version_ | 1818886219556192256 |
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| author | Christopher Burton Lynne Williams Tracey Bucknall Stephen Edwards Denise Fisher Beth Hall Gill Harris Peter Jones Matthew Makin Anne McBride Rachel Meacock John Parkinson Jo Rycroft-Malone Justin Waring |
| author_facet | Christopher Burton Lynne Williams Tracey Bucknall Stephen Edwards Denise Fisher Beth Hall Gill Harris Peter Jones Matthew Makin Anne McBride Rachel Meacock John Parkinson Jo Rycroft-Malone Justin Waring |
| author_sort | Christopher Burton |
| collection | DOAJ |
| description | Abstract 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. Systematic review registration PROSPERO CRD42017081030 |
| first_indexed | 2024-12-19T16:17:52Z |
| format | Article |
| id | doaj.art-acc3bf512fab473b84f6bdd7e0a7455e |
| institution | Directory Open Access Journal |
| issn | 2046-4053 |
| language | English |
| last_indexed | 2024-12-19T16:17:52Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj.art-acc3bf512fab473b84f6bdd7e0a7455e2022-12-21T20:14:35ZengBMCSystematic Reviews2046-40532019-08-01811710.1186/s13643-019-1111-8Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidenceChristopher Burton0Lynne Williams1Tracey Bucknall2Stephen Edwards3Denise Fisher4Beth Hall5Gill Harris6Peter Jones7Matthew Makin8Anne McBride9Rachel Meacock10John Parkinson11Jo Rycroft-Malone12Justin Waring13Noreen Edwards Chair of Rehabilitation and Nursing Research, Head of School, School of Health Sciences, Bangor UniversityBangor UniversitySchool of Nursing and Midwifery, Deakin UniversityBangor UniversityBangor UniversityBangor UniversityBetsi Cadwaladr University Health BoardBangor UniversityThe Pennine Acute Hospitals NHS TrustAlliance Manchester Business School, Manchester UniversityDivision of Population Health, Health Services Research and Primary Care, Manchester UniversityBangor UniversityBangor UniversityNottingham University Business School, Nottingham UniversityAbstract 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. Systematic review registration PROSPERO CRD42017081030http://link.springer.com/article/10.1186/s13643-019-1111-8De-implementationLow-value practiceOveruseHealth servicesConcept analysisRealist synthesis |
| spellingShingle | Christopher Burton Lynne Williams Tracey Bucknall Stephen Edwards Denise Fisher Beth Hall Gill Harris Peter Jones Matthew Makin Anne McBride Rachel Meacock John Parkinson Jo Rycroft-Malone Justin Waring Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence Systematic Reviews De-implementation Low-value practice Overuse Health services Concept analysis Realist synthesis |
| title | Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence |
| title_full | Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence |
| title_fullStr | Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence |
| title_full_unstemmed | Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence |
| title_short | Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence |
| title_sort | understanding how and why de implementation works in health and care research protocol for a realist synthesis of evidence |
| topic | De-implementation Low-value practice Overuse Health services Concept analysis Realist synthesis |
| url | http://link.springer.com/article/10.1186/s13643-019-1111-8 |
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