What strategies are used by clinician champions to reduce low-value care?
Background: Clinician champions are front-line clinicians who advocate for and influence practice change in their local context. The strategies they use when leading efforts to reduce the use of low-value care have not been well described. The purpose of this study is to identify and describe strate...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-01-01
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| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/20503121211069855 |
| _version_ | 1798016149803237376 |
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| author | Michael L Parchman Lorella G Palazzo Jessica M Mogk Janna C Webbon Lauren Demosthenes Elizabeth Vossenkemper George Hoke Joshua Moskovitz Leslie Dunlap Roberto Diaz del Carpio |
| author_facet | Michael L Parchman Lorella G Palazzo Jessica M Mogk Janna C Webbon Lauren Demosthenes Elizabeth Vossenkemper George Hoke Joshua Moskovitz Leslie Dunlap Roberto Diaz del Carpio |
| author_sort | Michael L Parchman |
| collection | DOAJ |
| description | Background: Clinician champions are front-line clinicians who advocate for and influence practice change in their local context. The strategies they use when leading efforts to reduce the use of low-value care have not been well described. The purpose of this study is to identify and describe strategies used by six clinician champions who led a low-value care initiative in their clinical setting. Methods: Qualitative data collected during an overuse reduction initiative led by clinician champions were used to identify strategies, guided by the Expert Recommendations for Implementing Change compilation of strategies. Clinician champions were asked to rank the importance of these activities and indicate which one of the six most important activities they would be willing to discuss in an interview. A 30-min semi-structured interview was conducted with each clinician about the activity they selected and thematically analyzed. Results: Twelve Expert Recommendations for Implementing Change strategies were identified. The top six strategies discussed during interviews were: build a coalition, conduct a local needs assessment, develop a formal implementation blueprint, conduct educational meetings, use facilitation, and develop clinical reminders. Common themes that emerged across all interviews were the use of data to engage clinicians in conversations, including the patient’s perspective in designing the interventions, and investing the time upfront to plan and launch the initiative because of the inherent challenges of relinquishing a service. Conclusions: Clinician champions identified multiple strategies as important when de-implementing a low-value service. Many were used to engage in conversations with stakeholders, including leadership, providers, and patients, to increase buy-in and support, challenge beliefs, promote behavior change, and gather insights about next steps in their effort. Future work is needed to better understand how prepare clinicians for this role and to understand the mechanisms through which these strategies might be effective. |
| first_indexed | 2024-04-11T15:46:10Z |
| format | Article |
| id | doaj.art-d08d564858684d6e9fcce1be0748d265 |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-04-11T15:46:10Z |
| publishDate | 2022-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-d08d564858684d6e9fcce1be0748d2652022-12-22T04:15:31ZengSAGE PublishingSAGE Open Medicine2050-31212022-01-011010.1177/20503121211069855What strategies are used by clinician champions to reduce low-value care?Michael L Parchman0Lorella G Palazzo1Jessica M Mogk2Janna C Webbon3Lauren Demosthenes4Elizabeth Vossenkemper5George Hoke6Joshua Moskovitz7Leslie Dunlap8Roberto Diaz del Carpio9Kaiser Permanente Washington Health Research Institute, Seattle, WA, USAKaiser Permanente Washington Health Research Institute, Seattle, WA, USAKaiser Permanente Washington Health Research Institute, Seattle, WA, USAKaiser Permanente Washington Health Research Institute, Seattle, WA, USAUniversity of South Carolina School of Medicine Greenville, Greenville, SC, USATri-Cities Community Health, Pasco, WA, USAUniversity of Virginia School of Medicine, Charlottesville, VA, USADepartment of Public Health, Hofstra School of Health and Human Services, New York, NY, USAUniversity of New Mexico Hospital, Albuquerque, NM, USACareMore Health, Cerritos, CA, USABackground: Clinician champions are front-line clinicians who advocate for and influence practice change in their local context. The strategies they use when leading efforts to reduce the use of low-value care have not been well described. The purpose of this study is to identify and describe strategies used by six clinician champions who led a low-value care initiative in their clinical setting. Methods: Qualitative data collected during an overuse reduction initiative led by clinician champions were used to identify strategies, guided by the Expert Recommendations for Implementing Change compilation of strategies. Clinician champions were asked to rank the importance of these activities and indicate which one of the six most important activities they would be willing to discuss in an interview. A 30-min semi-structured interview was conducted with each clinician about the activity they selected and thematically analyzed. Results: Twelve Expert Recommendations for Implementing Change strategies were identified. The top six strategies discussed during interviews were: build a coalition, conduct a local needs assessment, develop a formal implementation blueprint, conduct educational meetings, use facilitation, and develop clinical reminders. Common themes that emerged across all interviews were the use of data to engage clinicians in conversations, including the patient’s perspective in designing the interventions, and investing the time upfront to plan and launch the initiative because of the inherent challenges of relinquishing a service. Conclusions: Clinician champions identified multiple strategies as important when de-implementing a low-value service. Many were used to engage in conversations with stakeholders, including leadership, providers, and patients, to increase buy-in and support, challenge beliefs, promote behavior change, and gather insights about next steps in their effort. Future work is needed to better understand how prepare clinicians for this role and to understand the mechanisms through which these strategies might be effective.https://doi.org/10.1177/20503121211069855 |
| spellingShingle | Michael L Parchman Lorella G Palazzo Jessica M Mogk Janna C Webbon Lauren Demosthenes Elizabeth Vossenkemper George Hoke Joshua Moskovitz Leslie Dunlap Roberto Diaz del Carpio What strategies are used by clinician champions to reduce low-value care? SAGE Open Medicine |
| title | What strategies are used by clinician champions to reduce low-value care? |
| title_full | What strategies are used by clinician champions to reduce low-value care? |
| title_fullStr | What strategies are used by clinician champions to reduce low-value care? |
| title_full_unstemmed | What strategies are used by clinician champions to reduce low-value care? |
| title_short | What strategies are used by clinician champions to reduce low-value care? |
| title_sort | what strategies are used by clinician champions to reduce low value care |
| url | https://doi.org/10.1177/20503121211069855 |
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