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QUERI – Quality Enhancement Research Initiative

QUERI Citations

Wang V, Maciejewski ML, Helfrich CD, Weiner BJ. Working smarter not harder: Coupling implementation to de-implementation. Healthcare (Amsterdam, Netherlands). 2018 Jun 1; 6(2):104-107.
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Abstract: In this paper, we discuss de-implementation as an implicit part of implementation and organizational change, and consider its underlying processes of unlearning to discontinue or deviate from ineffective practice and learning to applying newer, more effective practices. We describe a typology of de-implementation that represents four types of change: partial reduction, complete reversal, substitution with related replacement and substitution with unrelated replacement of existing practice. We also explicate how learning and unlearning needed for effective change vary in these four types of de-implementation. Last, we propose coupling de-implementation and implementation efforts, which serve conceptual and logistical goals of organizational change.