Multicomponent processes to identify and prioritise low-value care in hospital settings: a scoping review.

Autor:	Tyack Z; Queensland University of Technology, Brisbane, Queensland, Australia z.tyack@qut.edu.au., Carter H; Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia., Allen M; Queensland University of Technology, Brisbane, Queensland, Australia., Senanayake S; Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia., Warhurst K; Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.; Mater Misericordiae Ltd, South Brisbane, Queensland, Australia., Naicker S; Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia., Abell B; Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia., McPhail SM; Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.; Metro South Health, Brisbane, Queensland, Australia.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Apr 11; Vol. 14 (4), pp. e078761. Date of Electronic Publication: 2024 Apr 11.
DOI:	10.1136/bmjopen-2023-078761
Abstrakt:	Objectives: This scoping review mapped and synthesised original research that identified low-value care in hospital settings as part of multicomponent processes. Design: Scoping review. Data Sources: Electronic databases (EMBASE, PubMed, CINAHL, PsycINFO and Cochrane CENTRAL) and grey literature were last searched 11 July and 3 June 2022, respectively, with no language or date restrictions. Eligibility Criteria: We included original research targeting the identification and prioritisation of low-value care as part of a multicomponent process in hospital settings. Data Extraction and Synthesis: Screening was conducted in duplicate. Data were extracted by one of six authors and checked by another author. A framework synthesis was conducted using seven areas of focus for the review and an overuse framework. Results: Twenty-seven records were included (21 original studies, 4 abstracts and 2 reviews), originating from high-income countries. Benefit or value (11 records), risk or harm (10 records) were common concepts referred to in records that explicitly defined low-value care (25 records). Evidence of contextualisation including barriers and enablers of low-value care identification processes were identified (25 records). Common components of these processes included initial consensus, consultation, ranking exercise or list development (16 records), and reviews of evidence (16 records). Two records involved engagement of patients and three evaluated the outcomes of multicomponent processes. Five records referenced a theory, model or framework. Conclusions: Gaps identified included applying systematic efforts to contextualise the identification of low-value care, involving people with lived experience of hospital care and initiatives in resource poor contexts. Insights were obtained regarding the theories, models and frameworks used to guide initiatives and ways in which the concept 'low-value care' had been used and reported. A priority for further research is evaluating the effect of initiatives that identify low-value care using contextualisation as part of multicomponent processes. Competing Interests: Competing interests: SMM was supported during the review period by an NHMRC fellowship (#1090440). KW discloses being supported by a grant, the Betty McGrath Health Care Delivery and Innovation Seeding Grant (Mater Research Limited), to Mater Health Limited. KW also received payments from The University of Queensland for lectures as Senior Lecturer (Honorary) and was co-chair of the Safer Baby Bundle Queensland Implementation Project Steering Committee. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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