De-implementation: A concept analysis

Abstract

Aim: The purpose of this concept analysis is to explore the meaning of de-implementation and provide a definition that can be used by researchers and clinicians to facilitate evidence-based practice. Background: De-implementation is a relatively unknown process overshadowed by the novelty of introducing new ideas and techniques into practice. Few studies have addressed the challenge of de-implementation and the cognitive processes involved when terminating harmful or unnecessary practices. Also, confusion exists regarding the myriad of terms used to describe de-implementation processes. Design: Walker and Avant's method (2011) for describing concepts was used to clarify de-implementation. Data source: A database search limited to academic journals yielded 281 publications representing basic research, study protocols, and editorials/commentaries from implementation science experts. After applying exclusion criterion of English language only and eliminating overlap between databases, 41 articles were selected for review. Review methods: Literature review and synthesis provided a concept analysis and a distinct definition of de-implementation. Results: De-implementation was defined as the process of identifying and removing harmful, non–cost-effective, or ineffective practices based on tradition and without adequate scientific support. Conclusions: The analysis provided further refinement of de-implementation as a significant concept for ongoing theory development in implementation science and clinical practice.