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Empirical and conceptual investigation of de-implementation of low-value care from professional and health care system perspectives: a study protocol

Overview of attention for article published in Implementation Science, May 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • Good Attention Score compared to outputs of the same age and source (72nd percentile)

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36 X users
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1 Facebook page

Citations

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17 Dimensions

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60 Mendeley
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Title
Empirical and conceptual investigation of de-implementation of low-value care from professional and health care system perspectives: a study protocol
Published in
Implementation Science, May 2018
DOI 10.1186/s13012-018-0760-7
Pubmed ID
Authors

Henna Hasson, Per Nilsen, Hanna Augustsson, Ulrica von Thiele Schwarz

Abstract

A considerable proportion of interventions provided to patients lacks evidence of their effectiveness. This implies that patients may receive ineffective, unnecessary, or even harmful care. Thus, in addition to implementing evidence-based practices, there is also a need to abandon interventions that are not based on best evidence, i.e., low-value care. However, research on de-implementation is limited, and there is a lack of knowledge about how effective de-implementation processes should be carried out. The aim of this project is to explore the phenomenon of the de-implementation of low-value health care practices from the perspective of professionals and the health care system. Theories of habits and developmental learning in combination with theories of organizational alignment will be used. The project's work will be conducted in five steps. Step 1 is a scoping review of the literature, and Step 2 has an explorative design involving interviews with health care stakeholders. Step 3 has a prospective design in which workplaces and professionals are shadowed during an ongoing de-implementation. In Step 4, a conceptual framework for de-implementation will be developed based on the previous steps. In Step 5, strategies for de-implementation are identified using a co-design approach. This project contributes new knowledge to implementation science consisting of empirical data, a conceptual framework, and strategy suggestions on de-implementation of low-value care. The professionals' perspectives will be highlighted, including insights into how they make decisions, handle de-implementation in daily practice, and what consequences it has on their work. Furthermore, the health care system perspective will be considered and new knowledge on how de-implementation can be understood across health care system levels will be obtained. The theories of habits and developmental learning can also offer insights into how context triggers and reinforces certain behaviors and how factors at the individual and the organizational levels interact. The project employs a solution-oriented perspective by developing a framework for de-implementation of low-value practices and suggesting practical strategies to improve de-implementation processes at all levels of the health care system. The framework and the strategies can thereafter be evaluated for their validity and impact in future studies.

X Demographics

X Demographics

The data shown below were collected from the profiles of 36 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 60 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 60 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 17%
Student > Master 10 17%
Other 8 13%
Student > Ph. D. Student 8 13%
Professor 2 3%
Other 8 13%
Unknown 14 23%
Readers by discipline Count As %
Medicine and Dentistry 11 18%
Nursing and Health Professions 7 12%
Psychology 5 8%
Business, Management and Accounting 4 7%
Social Sciences 3 5%
Other 9 15%
Unknown 21 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 22. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 February 2019.
All research outputs
#1,582,353
of 24,147,581 outputs
Outputs from Implementation Science
#299
of 1,753 outputs
Outputs of similar age
#34,727
of 331,196 outputs
Outputs of similar age from Implementation Science
#11
of 37 outputs
Altmetric has tracked 24,147,581 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,753 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.8. This one has done well, scoring higher than 83% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 331,196 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 37 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.