De‐implementation: A concept analysis

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.