Table 3 Number and percentages of the identified de-implementation strategies

Train and educate stakeholders

Conduct ongoing training

0

0%

Provide ongoing consultation

0

0%

Develop educational materials

106

34%

Make training dynamic

85

27%

Distribute educational materials

59

19%

Use train-the-trainer strategies

3

1%

Conduct educational meetings

64

21%

Conduct educational outreach visits

30

10%

Create a learning collaborative

3

1%

Shadow other experts

0

0%

Work with educational institutions

0

0%

Sum strategies

350^a

Use evaluative and iterative strategies

Assess for readiness and identify barriers and facilitators

10

3%

Audit and provide feedback

89

29%

Purposively reexamine the implementation

0

0%

Develop and implement tools for quality monitoring

3

1%

Develop and organize quality monitoring systems

86

28%

Develop a formal implementation blueprint

0

0%

Conduct local needs assessment

10

3%

Stage implementation scale up

2

1%

Obtain and use patients/consumers and family feedback

0

0%

Conduct cyclical small tests of change

6

2%

Sum strategies

206

Support clinicians

Facilitate relay of clinical data to providers

3

1%

Remind clinicians

92

30%

Develop resource sharing agreements

0

0%

Revise professional roles

2

1%

Create new clinical teams

3

1%

Sum strategies

100

Develop stakeholder interrelationships

Identify and prepare champions

15

5%

Organize clinician implementation team meetings

1

1%

Recruit, designate, and train for leadership

0

0%

Inform local opinion leaders

0

0%

Build a coalition

0

0%

Obtain formal commitment

9

3%

Identify early adopters

0

0%

Conduct local consensus discussions

1

1%

Capture and share local knowledge

0

0%

Use advisory boards and workgroups

28

9%

Use an implementation advisor

0

0%

Model and simulate change

0

0%

Visit other sites

0

0%

Involve executive boards

0

0%

Develop an implementation glossary

0

0%

Develop academic partnerships

0

0%

Promote network weaving

0

0%

Sum strategies

54

Change infrastructure

Mandate change

2

1%

Change record systems

1

1%

Change physical structure and equipment

38

12%

Create or change credentialing and/or licensure standards

0

0%

Change service sites

0

0%

Change accreditation or membership requirements

0

0%

Start a dissemination organization

1

1%

Change liability laws

0

0%

Sum strategies

40

Utilize financial strategies

Fund and contract for clinical innovation

0

0%

Access new founding

0

0%

Place innovation on fee for service lists/formularies

0

0%

Alter incentive/allowance structures

6

2%

Make billing easier

0

0%

Alter patient/consumer fees

3

1%

Use other payment schemes

4

1%

Develop disincentives

1

1%

Use capitated payments

0

0%

Sum strategies

14

Adapt and tailor to context

Tailor strategies

6

2%

Promote adaptability

0

0%

Use data experts

0

0%

Use data warehousing techniques

2

1%

Sum strategies

8

Provide interactive assistance

Facilitation

0

0%

Provide local technical assistance

0

0%

Centralize technical assistance

0

0%

Provide clinical supervision

5

2%

Sum strategies

5

Engage consumers

Involve patients/consumers and family members

0

0%

Intervene with patients/consumers to enhance uptake and adherence

0

0%

Prepare patients/consumers to be active participants

0

0%

Increase demand

0

0%

Use mass media

2

1%

Sum strategies

2

Added strategy by Perry et al.

Assess and redesign workflow

21

7%

Create online learning communities

0

0%

Engage community resources

0

0%

Strategies not found

Accountability tool

22

7%

FDA black box warning

1

1%

Policy and regulations

5

2%

Communication tool

9

3%

International collaboration

1

1%