Open AccessBarriers and Facilitators to De-Implementation of the Choosing Wisely® Guidelines for Low-Value Breast Cancer Surgery
Author(s) -
Margaret E. Smith,
C. Ann Vitous,
Tasha M. Hughes,
Sarah P. Shubeck,
Reshma Jagsi,
Lesly A. Dossett
Publication year - 2020
Publication title -
annals of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.764
H-Index - 173
eISSN - 1534-4681
pISSN - 1068-9265
DOI - 10.1245/s10434-020-08285-0
Subject(s) - medicine , psychological intervention , thematic analysis , surgical oncology , breast cancer , best practice , family medicine , cancer , surgery , qualitative research , nursing , social science , management , sociology , economics
To address overuse of unnecessary practices, several surgical organizations have participated in the Choosing Wisely ® campaign and identified four breast cancer surgical procedures as unnecessary. Despite evidence demonstrating no survival benefit for all four, evidence suggests only two have been substantially de-implemented. Our objective was to understand why surgeons stop performing certain unnecessary cancer operations but not others and how best to de-implement entrenched and emerging unnecessary procedures.