How to Reduce Overuse in Healthcare (häftad)
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How to Reduce Overuse in Healthcare

A Practical Guide

Häftad,  Engelska, 2023-09-01
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HOW TO REDUCE OVERUSE IN HEALTHCARE Reduce low-value care with this practical guide Low-value care harms patients, overburdens healthcare professionals, threatens healthcare systems and damages the climate. How to Reduce Overuse in Healthcare: a practical guide is designed to provide practical guidance and tools for healthcare providers, their professional societies and policy makers developing programs to de-implement low-value or unnecessary care. This guide provides a five-step evidence and theory-based framework for developing and evaluating programs such as Choosing Wisely to reduce low-value care and improve patient outcomes. How to Reduce Overuse in Healthcare: a practical guide readers will also find: An author team involved in the leading Choosing Wisely international network Detailed analysis of how to identify potential low-value care areas, select interventions and more Practical, real-world examples at the end of each chapter illustrating examples of overuse and de-implementation How to Reduce Overuse in Healthcare: a practical guide describes the state of the art in de-implementation for healthcare professionals, healthcare administrators and policy makers looking to reduce low-value care in a more effective and evidence-based way.
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Övrig information

Tijn Kool, MD PhD, is Full Professor Appropriate Care at the Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands. Andrea M. Patey, PhD, is Senior Research Associate in the Centre for Implementation Research in the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Canada. Simone van Dulmen, PhD, is Senior Researcher in Appropriate and Sustainable Healthcare at the Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands. Jeremy M. Grimshaw, MBChB, PhD, Senior Scientist in the Centre for Implementation Research in the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Canada.


Preface x Chapter 1 Why Should We Reduce Medical Overuse? 1 Karen Born and Wendy Levinson It Started with Quality Improvement 1 Then Came a Focus on Overuse 3 Overuse as a Global Healthcare Quality Concern 5 What Can Be Done to Address Overuse? 6 Choosing Wisely 7 What Can you Expect in the Following Chapters? 9 References 10 Chapter 2 Why Does Overuse Exist? 13 Tijn Kool, Simone van Dulmen, Andrea M. Patey, and Jeremy M. Grimshaw A Multifactorial Challenge on Different Levels 13 Healthcare Professional Factors 14 Patient Factors 15 Preference for Acquiring Something 16 Clinical Care Context Factors 16 Absence of an Open Culture 17 Absence of Clear Leadership 17 Healthcare Organisation Factors 18 Insufficient Time 18 Lack of Coordination Amongst Healthcare Providers 19 Healthcare System Factors 19 Payment System that Rewards Volume 19 Influence of the Pharmaceutical and Medical Device Industry 20 Healthcare Insurance Policy 20 Key Points 20 References 21 Chapter 3 Why Is It So Hard to Change Behaviour and How Can We Influence It? 23 Jill J. Francis, Sanne Peters, Andrea M. Patey, Nicola McCleary, Leti van Bodegom- Vos, and Harriet Hiscock The Challenge of Behaviour Change 24 Is The Behaviour a Routine? 24 Is The Behaviour Rewarding? 24 Do Habits or Routines Play a Role in Sustaining the Behaviour? 26 Four Crucial Questions to Address Before Working to Support Behaviour Change 28 Why Is It So Difficult to Change the Behaviour of Healthcare Professionals? 30 Designing Interventions to Change Behaviour 35 Summary 36 Sources of Information for Supporting Practice Change Among Healthcare Professionals 36 References 36 Chapter 4 How Can We Reduce Overuse: The Choosing Wisely De- Implementation Framework 41 Jeremy M. Grimshaw and Andrea M. Patey Introduction 41 The Choosing Wisely De- Implementation Framework 44 Phase 0: Identification of Potential Areas of Low- Value Healthcare 44 Phase 1: Identification of Local Prioritiesfor the Implementation of Recommendations 45 Phase 2: Identification of Barriers and Enablers to Implementing Recommendations and Potential Interventions to Overcome These 46 Phase 3: Evaluation of the Implementation 48 Phase 4: Spread of Effective Implementation Programs 49 Key Points 50 References 51 Chapter 5 How Can You Engage Patients in De- Implementation Activities? 54 Stuart G. Nicholls, Brian Johnston, Barbara Sklar, and Holly Etchegary What Is Patient Engagement and Why is it Relevant to De- Implementation? 54 Making a Patient Engagement Plan 56 The Level of Engagement 57 Area 1 Patient Engagement in Agenda Setting and Prioritisation 61 Area 2 Patient Engagement in the Design and Conduct of De- Implementation Activities 64 Area 3 Patient Engagement in Spread 65 Important Considerations when Engaging Patients 66 Key Points 68 Sources of Information 69 General Resources 69 Planning Tools 69 Patient Engagement Methods 70 Evaluation Tools 70 References 70 Chapter 6 Identifying Potential Areas of Low- Value Healthcare- Phase 0 73 Moriah E. Ellen, Saritte M. Perlman, and Jeremy M. Grimshaw How to Identify Low- Value Care? 73 Resources to Identify Low- Value Care 75 Recommendation Lists 76 Clinical Practice Guidelines 77 Health Technology Assessments 77 Evidence Syntheses and Systematic Reviews 78 From Identification to Measurement 78 Key Points 84 Sources of Further Information 84 References 84 Chapter 7 Measuring Low- Value Care and Choosing Your Local Priority (Phase 1) 88 Carole E. Aubert, Karen Born, Eve A. Kerr, Sacha Bhatia, and Eva W. Verkerk Choosing Your Local Priority 89 Measuring Low- Value Care 89 Baseline Measurements 90 Estimating Improvement Potential 91 Evaluating De- Implementation Effects 91 Measuring Unintended Consequences 94 Measurement Methods and Data Source 95 Setting Specific, Measurable, Achievable, Relevan