Selecting De-Implementation Strategies and Designing Interventions: Phase 2b

Following the activities described in the previous chapters, you are now ready to (finally) start designing your intervention. For budding and seasoned de-implementers alike, there may have been a temptation to skip ahead to this chapter. And those of you working ‘at the coal face’, on the ground, with the lived experience and expertise, you undoubtedly already have a list of several possible de-implementation strategies worth considering. But there is a reason that this chapter about selecting de-implementation strategies and designing interventions is the ninth rather than the first chapter. It is important not to rush to solutions, but instead to first consider barriers and enablers and then match the choice of strategies to those best addressing identified barriers and enablers. Now that you are ready to start designing, this chapter describes 10 general principles and key steps for selecting de-implementation strategies to enable you to draw from state-of-the-art tools and the broader understanding of how best to de-implement low-value care.