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123 How to design and disseminate de-implementation interventions?
  1. Simone van Dulmen1,
  2. Danielle Kroon1,
  3. Andrea Patey2,
  4. Tijn Kool1
  1. 1Radboud University Medical Center, Nijmegen, Netherlands
  2. 2University of Ottawa, Ottawa, Canada


Background Low-value care does not benefit the patient and may in fact lead to potential harms, be more costly and not reflect preferences of the patient. Low-value care can be reduced by targeted interventions, also called de-implementation interventions. While evidence exists about how to implement evidence-based practices in general, there has been less attention focused on the challenge of implementing recommendations to reduce low-value healthcare. After a de-implementation intervention is designed and successful at reducing low-value care, even less is known about how interventions can be disseminated to other organizations.

Research teams in Canada and the Netherlands in collaboration with Choosing Wisely International have developed tools and frameworks to assist in the design and evaluation of de-implementation interventions. In addition, we have developed a framework of determinants to consider when planning to scale and disseminate effective de-implementation interventions. This workshop will be an opportunity to share our knowledge and experience, stimulate the interaction to using the developed frameworks for reducing low-value care, and to share the experiences and views of the audience of the workshop.

Aims The aims of this workshop are:

  1. To present the theoretical background on de-implementation and dissemination, guided with frameworks and examples of successful large scale de-implementation interventions and dissemination projects.

  2. To provide opportunities for a group in how to design a dissemination strategy.

Method The workshop will consist of three parts:

  1. We will go stepwise through all phases of de-implementation: from identification of potential low-value healthcare to identification of local priorities and barriers, designing interventions to overcome barriers, evaluation of the interventions and spread of effective de-implementations.

  2. We will provide examples of successful large scale de-implementation and dissemination projects from Canada and the Netherlands, such as inappropriate vitamin testing in primary care, and laboratory testing and pre-operative testing in hospitals. We will provide examples on how to consider the determinants from a dissemination framework and targeted those that were relevant and those we could influence. Because of the differences in setting and context, the strategies differed among the projects.

  3. The audience will be working on the design of their own dissemination plan and share their knowledge and experience. During this part of the workshop, we will select a few initiatives that are of interest of the audience. In smaller groups the audience will design a dissemination strategy of the selected initiatives. These strategies will be presented to the audience.

Results Participants will gain knowledge of all phases of de-implementation. They will have knowledge about influencing factors that are of specific importance for disseminating de-implementation interventions. The participants will have the opportunity to share their own ideas and experiences and receive feedback from the public. This information can be used for tackling the factors in the development of their own de-implementation and dissemination projects.

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