Success factors for interventions to reduce low-value imaging. Six crucial lessons learned from a practical case study in Norway.

de-implementation imaging implementation intervention low-value

Journal

Current problems in diagnostic radiology
ISSN: 1535-6302
Titre abrégé: Curr Probl Diagn Radiol
Pays: United States
ID NLM: 7607123

Informations de publication

Date de publication:
14 Aug 2024
Historique:
received: 19 04 2024
revised: 28 07 2024
accepted: 08 08 2024
medline: 21 8 2024
pubmed: 21 8 2024
entrez: 20 8 2024
Statut: aheadofprint

Résumé

Substantial overuse of health care services is identified and intensified efforts are incited to reduce low-value services in general and in imaging in particular. To report crucial success factors for developing and implementing interventions to reduce specific low-value imaging examinations based on a case study in Norway. Mixed methods design including one systematic review, one scoping review, implementation science, qualitative interviews, content analysis of stakeholders' input, and stakeholder deliberations. The description and analysis of an intervention to reduce low-value imaging in Norway identifies six general success factors: 1) Acknowledging complexity: advanced knowledge synthesis, competence of the context, and broad and strong stakeholder involvement is crucial to manage de-implementation complexity. 2) Clear consensus-based criteria for selecting low-value imaging procedures are key. 3) Having a clear target group is critical. 4) Stakeholder engagement is essential to ascertain intervention relevance and compliance. 5) Active and well-motivated intervention collaborators is imperative. 6) Paying close attention to the mechanisms of low-value imaging and the barriers to reduce it is decisive. Reducing low-value imaging is crucial to increase the quality, safety, efficiency, and sustainability of the health services. Reducing low-value imaging is a complex task and paying attention to specific practical success factors is key.

Sections du résumé

BACKGROUND BACKGROUND
Substantial overuse of health care services is identified and intensified efforts are incited to reduce low-value services in general and in imaging in particular.
OBJECTIVE OBJECTIVE
To report crucial success factors for developing and implementing interventions to reduce specific low-value imaging examinations based on a case study in Norway.
MATERIALS AND METHODS METHODS
Mixed methods design including one systematic review, one scoping review, implementation science, qualitative interviews, content analysis of stakeholders' input, and stakeholder deliberations.
RESULTS RESULTS
The description and analysis of an intervention to reduce low-value imaging in Norway identifies six general success factors: 1) Acknowledging complexity: advanced knowledge synthesis, competence of the context, and broad and strong stakeholder involvement is crucial to manage de-implementation complexity. 2) Clear consensus-based criteria for selecting low-value imaging procedures are key. 3) Having a clear target group is critical. 4) Stakeholder engagement is essential to ascertain intervention relevance and compliance. 5) Active and well-motivated intervention collaborators is imperative. 6) Paying close attention to the mechanisms of low-value imaging and the barriers to reduce it is decisive.
CONCLUSION CONCLUSIONS
Reducing low-value imaging is crucial to increase the quality, safety, efficiency, and sustainability of the health services. Reducing low-value imaging is a complex task and paying attention to specific practical success factors is key.

Identifiants

pubmed: 39164183
pii: S0363-0188(24)00150-6
doi: 10.1067/j.cpradiol.2024.08.007
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Competing interests The authors declare that they have no competing interests.

Auteurs

Bjørn Hofmann (B)

Institute for the Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Norway; Centre for Medical Ethics, University of Oslo, Norway. Electronic address: bjoern.hofmann@ntnu.no.

Eivind Richter Andersen (ER)

Institute for the Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Norway.

Ingrid Øfsti Brandsæter (IØ)

Institute for the Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Norway.

Fiona Clement (F)

Department of Community Health Sciences, Cumming School of Medicine. University of Calgary, Canada.

Adam G Elshaug (AG)

Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Australia.

Stirling Bryan (S)

School of Population & Public Health, University of British Columbia, Vancouver, Canada.

Aslak Aslaksen (A)

Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Global Health and Primary Care, University of Bergen, Bergen, Norway.

Stefán Hjørleifsson (S)

Department of Global Health and Primary Care, University of Bergen, Bergen, Norway.

Peter Mæhre Lauritzen (PM)

Division of radiology and nuclear medicine, Oslo University Hospital, Oslo Norway; Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Norway.

Bente Kristin Johansen (BK)

The Norwegian Medical Association, Oslo, Norway.

Gregor Jarosch von Schweder (GJ)

Evidia Norway, Norway.

Fredrik Nomme (F)

Unilabs Norway, Norway.

Elin Kjelle (E)

Institute for the Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Norway.

Classifications MeSH