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.