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Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence
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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683493/ https://www.ncbi.nlm.nih.gov/pubmed/31383018 http://dx.doi.org/10.1186/s13643-019-1111-8 |
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author | 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 Waring, Justin |
author_facet | 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 Waring, Justin |
author_sort | Burton, Christopher |
collection | PubMed |
description | 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 |
format | Online Article Text |
id | pubmed-6683493 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66834932019-08-09 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 Waring, Justin Syst Rev Protocol 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 BioMed Central 2019-08-05 /pmc/articles/PMC6683493/ /pubmed/31383018 http://dx.doi.org/10.1186/s13643-019-1111-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Protocol 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 Waring, Justin Understanding how and why de-implementation works in health and care: research protocol for a realist synthesis of evidence |
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 | Protocol |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683493/ https://www.ncbi.nlm.nih.gov/pubmed/31383018 http://dx.doi.org/10.1186/s13643-019-1111-8 |
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