How to Reduce Overuse in Healthcare

Name: How to Reduce Overuse in Healthcare | A Practical Guide
Brand: Wiley
Price: 45.99 EUR
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A Practical Guide

Tijn Kool Andrea M. Patey Simone van Dulmen Jeremy M. Grimshaw(Herausgeber*in)

Wiley (Verlag)

1. Auflage

Erschienen am 4. August 2023

240 Seiten

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Inhalt

Cover
Title Page
Copyright Page
Contents
Preface
Chapter 1 Why Should We Reduce Medical Overuse?
It Started with Quality Improvement
Then Came a Focus on Overuse
Overuse as a Global Healthcare Quality Concern
What Can Be Done to Address Overuse?
Choosing Wisely
What Can you Expect in the FollowingChapters?
References
Chapter 2 Why Does Overuse Exist?
A Multifactorial Challenge on Different Levels
Healthcare Professional Factors
Patient Factors
Clinical Care Context Factors
Healthcare Organisation Factors
Healthcare System Factors
Payment System that Rewards Volume
Influence of the Pharmaceutical and Medical Device Industry
Healthcare Insurance Policy
KEY POINTS
References
Chapter 3 Why Is It So Hard to Change Behaviour and How Can We Influence It?
The Challenge of Behaviour Change
Is The Behaviour a Routine?
Is The Behaviour Rewarding?
Do Habits or Routines Play a Role in Sustaining the Behaviour?
Four Crucial Questions to Address Before Working to Support Behaviour Change
Why Is It So Difficult to Change the Behaviour of Healthcare Professionals?
Designing Interventions to Change Behaviour
Summary
Sources of Information for Supporting Practice Change Among Healthcare Professionals
References
Chapter 4 How Can We Reduce Overuse: The Choosing Wisely De-Implementation Framework
Introduction
The Choosing Wisely De-Implementation Framework
Phase 0: Identification of Potential Areas of Low-Value Healthcare
Phase 1: Identification of Local Priorities for the Implementation of Recommendations
Phase 2: Identification of Barriers and Enablers to Implementing Recommendations and Potential Interventions to Overcome These
Phase 3: Evaluation of the Implementation
Phase 4: Spread of Effective Implementation Programs
KEY POINTS
References
Chapter 5 How Can You Engage Patients in De-Implementation Activities?
What Is Patient Engagement and Why is it Relevant to De-Implementation?
Making a Patient Engagement Plan
The Level of Engagement
Area 1 - Patient Engagement in Agenda Setting and Prioritisation
Area 2 - Patient Engagement in the Design and Conduct of De-Implementation Activities
Area 3 - Patient Engagement in Spread
Important Considerations when Engaging Patients
Sources of Information
General Resources
Planning Tools
Patient Engagement Methods
Evaluation Tools
References
Chapter 6 Identifying Potential Areas of Low-Value Healthcare-Phase 0
How to Identify Low-Value Care?
Resources to Identify Low-Value Care
From Identification to Measurement
KEY POINTS
Sources of Further Information
FURTHER READING
Chapter 7 Measuring Low-Value Care and Choosing Your Local Priority (Phase 1)
Choosing Your Local Priority
Measuring Low-Value Care
Baseline Measurements
Estimating Improvement Potential
Evaluating De-Implementation Effects
Measuring Unintended Consequences
Measurement Methods and Data Source
Setting Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) Targets
Providing Data and Feedback to Stakeholders
KEY POINTS
References
Chapter 8 Identifying Target Behaviours and Potential Barriers to Change (Phase 2a)
The Importance of Fully Understanding the Problem
Getting Started
Identifying Who Needs to do What Differently
Using the Action, Actor, Context, Target, Time (Aactt) Framework
Identifying Drivers of Current Behaviour and Barriers and Enablers to Changing Behaviour
Collecting Data
Interviews
Focus Groups
Surveys
Analysing the Data
Narrowing Down the Drivers or Barriers Identified
KEY POINTS
Useful Resources
References
Appendix: Sample Interview Guide for Healthcare Providers Using the Tdf
Introduction Script
Background
Chapter 9 Selecting De-Implementation Strategies and Designing Interventions: Phase 2b
WHAT DO YOU NEED TO DO BEFORE SELECTING DE-IMPLEMENTATION STRATEGIES?
Ten General Principles to Consider as you Develop a de-Implementation Intervention
1. There Are No Magic Bullets: Design Your De-Implementation Intervention to Address Specific Barriers and Enablers
2. De-Implementation Interventions Are Often Also Implementation Interventions when Substituting One Practice with Another
3. Routinised, Habitually Performed Care May Be Operating Semi-Automatically
4. Follow the Evidence Wherever Possible when Designing Your De-Implementation Intervention
5. Avoid the Tower of Babel: Leverage Existing Lists of Change Strategies and Use Them to Help Match Specific Strategies to Identified Barriers/Enablers
6. Avoid Conflating Intervention Content with Its Method of Delivery
7. Decide on Tailoring and Adaptation
8. Co-Development, User-Centred Design to Enhance Feasibility, Acceptability, and Implementability
9. Prioritise Equity
10. Describe How the Strategy Works by Developing a De-Implementation Logic Model of Change
KEY POINTS
Sources
References
Chapter 10 Evaluating De-Implementation Interventions: Phase 3
WHY SHOULD WE EVALUATE?
OUTCOMES
Types of Evaluations
Randomised Evaluations
Non-Randomised Evaluations
Selecting the Most Appropriate Evaluation Method
How and Why Does the Intervention Work?
Does the Intervention Offer Good Value for Money?
KEY POINTS
References
Chapter 11 Preserving Results and Spreading Interventions: Phase 4
Why Are Sustainability And Spread So Important?
What Is Sustainability?
Factors Influencing Sustained Change
Factors Related to the Process
Factors Related to Staff
Factors Related to the Organisation
How Can You Facilitate Sustainability?
Assessing Sustainability
Sustainability and Culture
Spreading Successful De-Implementation Interventions
Scaling Strategy
De-Implementation Intervention
Adopters or Adopting Organisation
External Context
KEY POINTS
References
Chapter 12 Training the Next Generation of Healthcare Providers to Address Overuse and Avoid Low-Value Care
Introduction
High-Value Care Competencies
Teaching Students And Trainees To Provide High-Value Care
Educational Changes to the Formal Curriculum
Faculty Role Modelling and Supportive Learning Environments
Assessing High-Value Care Learning Outcomes
Enablers of Educational Change
Aligning Continuing Professional Development and Quality Improvement
KEY POINTS
Sources
References
Chapter 13 Examples from Clinical Practice
Introduction
References
Chapter 14 Starting Tomorrow
Index
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