Skip to main content
Log in

De-implementing low value care in critically ill patients: a call for action—less is more

  • Less is More in ICU
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Cassel CK, Guest JA (2012) Choosing wisely: helping physicians and patients make smart decisions about their care. JAMA 307:1801–1802

    Article  CAS  Google Scholar 

  2. Elshaug AG, Rosenthal MB, Lavis JN, Brownlee S, Schmidt H, Nagpal S, Littlejohns P, Srivastava D, Tunis S, Saini V (2017) Levers for addressing medical underuse and overuse: achieving high-value health care. Lancet 390:191–202

    Article  Google Scholar 

  3. Badgery-Parker T, Pearson S-A, Dunn S, Elshaug AG (2019) Measuring hospital-acquired complications associated with low-value care. JAMA Intern Med 179:499–505

    Article  Google Scholar 

  4. Korenstein D, Chimonas S, Barrow B, Keyhani S, Troy A, Lipitz-Snyderman A (2018) Development of a conceptual map of negative consequences for patients of overuse of medical tests and treatments. JAMA Intern Med 178:1401–1407

    Article  Google Scholar 

  5. Niven DJ, Rubenfeld GD, Kramer AA, Stelfox HT (2015) Effect of published scientific evidence on glycemic control in adult intensive care units. JAMA Intern Med 175:801–809

    Article  Google Scholar 

  6. Montini T, Graham ID (2015) “Entrenched practices and other biases”: unpacking the historical, economic, professional, and social resistance to de-implementation. Implement Sci 10:24

    Article  Google Scholar 

  7. Helfrich CD, Rose AJ, Hartmann CW, van Bodegom-Vos L, Graham ID, Wood SJ, Majerczyk BR, Good CB, Pogach LM, Ball SL, Au DH, Aron DC (2018) How the dual process model of human cognition can inform efforts to de-implement ineffective and harmful clinical practices: a preliminary model of unlearning and substitution. J Eval Clin Pract 24:198–205

    Article  Google Scholar 

  8. Sauro K, Bagshaw SM, Niven D, Soo A, Brundin-Mather R, Parsons Leigh J, Cook DJ, Stelfox HT (2019) Barriers and facilitators to adopting high value practices and de-adopting low value practices in Canadian intensive care units: a multimethod study. BMJ Open 9:e024159–e024159

    Article  Google Scholar 

  9. Koo KK, Sun JC, Zhou Q, Guyatt G, Cook DJ, Walter SD, Meade MO (2011) Pulmonary artery catheters: evolving rates and reasons for use. Crit Care Med 39:1613–1618

    Article  Google Scholar 

  10. Wiener RS, Welch HG (2007) Trends in the use of the pulmonary artery catheter in the United States, 1993–2004. JAMA 298:423–429

    Article  CAS  Google Scholar 

  11. Upvall MJ, Bourgault AM (2018) De-implementation: a concept analysis. Nurs Forum 53:376–382

    Article  Google Scholar 

  12. Norton WE, Chambers DA, Kramer BS (2019) Conceptualizing de-implementation in cancer care delivery. J Clin Oncol 37:93–96

    Article  Google Scholar 

  13. Niven DJ, Mrklas KJ, Holodinsky JK, Straus SE, Hemmelgarn BR, Jeffs LP, Stelfox HT (2015) Towards understanding the de-adoption of low-value clinical practices: a scoping review. BMC Med 13:255

    Article  Google Scholar 

  14. Kahn JM, Le TQ (2016) Adoption and de-adoption of drotrecogin alfa for severe sepsis in the United States. J Crit Care 32:114–119

    Article  CAS  Google Scholar 

  15. Lyu PF, Hockenberry JM, Gaydos LM, Howard DH, Buchman TG, Murphy DJ (2016) Impact of a sequential intervention on albumin utilization in critical care. Crit Care Med 44:1307–1313

    Article  Google Scholar 

  16. Stelfox HT, Brundin-Mather R, Soo A, Parsons Leigh J, Niven DJ, Fiest KM, Doig CJ, Zuege DJ, Kushner B, Clement F, Straus SE, Cook DJ, Bagshaw SM, Sauro KM (2019) A multicentre controlled pre-post trial of an implementation science intervention to improve venous thromboembolism prophylaxis in critically ill patients. Intensive Care Med 45:211–222

    Article  Google Scholar 

  17. Niven DJ, McCormick TJ, Straus SE, Hemmelgarn BR, Jeffs L, Barnes TRM, Stelfox HT (2018) Reproducibility of clinical research in critical care: a scoping review. BMC Med 16:26

    Article  Google Scholar 

  18. Bourgault AM, Upvall MJ (2019) De-implementation of tradition-based practices in critical care: a qualitative study. Int J Nurs Pract 25:1–9

    Article  Google Scholar 

  19. Gershengorn HB, Wunsch H, Scales DC, Rubenfeld GD (2018) Trends in use of daily chest radiographs among US adults receiving mechanical ventilation. JAMA Netw Open 1:e181119

    Article  Google Scholar 

  20. Munshi L, Gershengorn HB, Fan E, Wunsch H, Ferguson ND, Stukel TA, Rubenfeld GD (2017) Adjuvants to mechanical ventilation for acute respiratory failure. adoption, de-adoption, and factors associated with selection. Ann Am Thorac Soc 14:94–102

    Article  Google Scholar 

  21. Gershengorn HB, Wunsch H (2013) Understanding changes in established practice: pulmonary artery catheter use in critically ill patients. Crit Care Med 41:2667–2676

    Article  Google Scholar 

  22. Menegueti MG, Ciol MA, Bellissimo-Rodrigues F, Auxiliadora-Martins M, Gaspar GG, Canini S, Basile-Filho A, Laus AM (2019) Long-term prevention of catheter-associated urinary tract infections among critically ill patients through the implementation of an educational program and a daily checklist for maintenance of indwelling urinary catheters: a quasi-experimental study. Medicine (Baltimore) 98:e14417

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Henry T. Stelfox.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stelfox, H.T., Bourgault, A.M. & Niven, D.J. De-implementing low value care in critically ill patients: a call for action—less is more. Intensive Care Med 45, 1443–1446 (2019). https://doi.org/10.1007/s00134-019-05694-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-019-05694-y

Keywords

Navigation