2020
DOI: 10.12788/jhm.3467
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Deimplementation of Established Medical Practice Without Intervention: Does It Actually Happen?

Abstract: I n this edition of the Journal of Hospital Medicine, Fenster and colleagues evaluate the trend of postdischarge intravenous (IV) antibiotic therapy for children with osteomyelitis, complicated pneumonia, and complicated appendicitis. 1 Children requiring prolonged antibiotic therapy were historically discharged home with a peripherally inserted central catheter (PICC) for IV antibiotics. Recent studies suggest that treatment failure occurs uncommonly, and that oral antibiotics are as effective as those admini… Show more

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Cited by 2 publications
(3 citation statements)
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References 18 publications
(25 reference statements)
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“…Five hospitals consistently reduced testing rates over 10 years with no clear worsening of clinical outcomes. We know from previous studies that changing clinical practice patterns and hospital-wide culture change can be difficult to achieve, 36,37 so this degree of consistency would be unusual without specific and consistent interventions. In addition, a second pattern emerged around sustainability.…”
Section: Discussionmentioning
confidence: 99%
“…Five hospitals consistently reduced testing rates over 10 years with no clear worsening of clinical outcomes. We know from previous studies that changing clinical practice patterns and hospital-wide culture change can be difficult to achieve, 36,37 so this degree of consistency would be unusual without specific and consistent interventions. In addition, a second pattern emerged around sustainability.…”
Section: Discussionmentioning
confidence: 99%
“…However, there is ample evidence that deimplementation can be difficult. 21 Building in deimplementation mechanisms, such as standing educational sessions or hospital committees dedicated to value that review practices, from the beginning may ease these changes.…”
Section: Strategies For Hvc Practice During Future Major Eventsmentioning
confidence: 99%
“…It is inevitable that some practices implemented early in pandemic response may need to be deimplemented later as the evidence and situation evolve. However, there is ample evidence that deimplementation can be difficult 21 . Building in deimplementation mechanisms, such as standing educational sessions or hospital committees dedicated to value that review practices, from the beginning may ease these changes.…”
Section: Strategies For Hvc Practice During Future Major Eventsmentioning
confidence: 99%