Journal
HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION
Volume 6, Issue 2, Pages 104-107Publisher
ELSEVIER
DOI: 10.1016/j.hjdsi.2017.12.004
Keywords
De-implementation; Organizational change; Learning; Unlearning
Funding
- Department of Veterans Affairs (VA) Quality Enhancement Research Initiative [QUE-16-170, QUE-15-271]
- VA Research Career Scientist award [RCS 10-391]
- Center of Innovation for Health Services Research in Primary Care at the Durham VA Health Care System [CIN 13-410]
- Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care at the VA Puget Sound Health Care System [CIN 13-402]
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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.
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