De-implementation

Abstract

“De-implementation” refers to processes for the deliberate removal, reduction, restriction, and replacement of established interventions, programs, and services. It is increasingly recognized as a requirement of evidence-based healthcare. In some ways, de-implementation is simply the reverse of implementation, and therefore, much of what we know about implementation science can simply be applied “in reverse”. However, de-implementation is also different in some crucial respects. The evidence to support removal of an established practice is often limited, and this adds to the wider challenges of convincing patients and other affected parties of the necessity and benefits of the proposed change. De-implementation is, therefore, more likely to experience resistance than other change processes.