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2019 HSR&D/QUERI National Conference Abstract

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3008 — Defining, Conceptualizing, and Studying De-implementation in Health

Lead/Presenter: Christian Helfrich,  COIN - Seattle/Denver
All Authors: Helfrich CD, Seattle-Denver COIN; McCullough M, Bedford-Boston COIN; Sayre G, Seattle-Denver COIN;

Workshop Objectives:
Ineffective clinical and public health practices often persist well after they've been demonstrated to provide no benefit, or when the harms outweigh the benefits. By some estimates, approximately 30% of health care provided in the US is low-value. Efforts to curb, or de-implement, low-value health practices and programs are often analogous to efforts to implement high-value practices and programs. However, de-implementation entails some unique dynamics and challenges, and opportunities. In this workshop participants will learn key terms, concepts, and frameworks that have been applied to de-implementation research and initiatives. Participants will then engage in a combination of small-group and large-group discussions of de-identified interview data from de-implementation trials to identify and describe factors influencing de-implementation efforts. At the conclusion of the workshop participants will be able to: 1. Understand low value care and de-implementation terms, concepts, and frameworks 2. Anticipate potential barriers and factors to be measured or assessed 3. Develop solutions to address barriers to de-implementation of low value care

Activities:
1. Understand low value care and de-implementation terms, concepts, and frameworks. Presentation (30 minutes) on the current de-implementation literature, including terms, concepts and frameworks that have been applied to de-implementation, and key related empirical findings. 2. Anticipating potential barriers and factors to be measured or assessed Small group (15 minutes) discussions of de-identified interview data from de-implementation trials to identify and describe factors that present unique challenges or opportunities when planning interventions. Report out to the large group (15 minutes). 3. Developing solutions to address barriers to de-implementation of low value care Small group (15 minutes) brainstorming and discussion of potential strategies and frameworks to apply address the factors from activity 2. Report out to the large group (15 minutes)

Target Audience:
Health services researchers and operational partners interested in understanding the current state of research on strategies to curb low-value care and how to advance rigorous, practical work in this area. Clinicians interested in addressing specific low value care practices.

Assumed Audience Familiarity with Topic:
No experience with de-implementation research or efforts is necessary. The workshop is geared to any audience with experience providing healthcare or researching it.