Success factors for interventions to reduce low-value imaging. Six crucial lessons learned from a practical case study in Norway

Abstract

Background Substantial overuse of health care services is identified and intensified efforts are incited to reduce low-value services in general and in imaging in particular. Objective To report crucial success factors for developing and implementing interventions to reduce specific low-value imaging examinations based on a case study in Norway. Materials and methods Mixed methods design including one systematic review, one scoping review, implementation science, qualitative interviews, content analysis of stakeholders’ input, and stakeholder deliberations. Results The description and analysis of an intervention to reduce low-value imaging in Norway identifies six general success factors: 1) Acknowledging complexity: advanced knowledge synthesis, competence of the context, and broad and strong stakeholder involvement is crucial to manage de-implementation complexity. 2) Clear consensus-based criteria for selecting low-value imaging procedures are key. 3) Having a clear target group is critical. 4) Stakeholder engagement is essential to ascertain intervention relevance and compliance. 5) Active and well-motivated intervention collaborators is imperative. 6) Paying close attention to the mechanisms of low-value imaging and the barriers to reduce it is decisive. Conclusion Reducing low-value imaging is crucial to increase the quality, safety, efficiency, and sustainability of the health services. Reducing low-value imaging is a complex task and paying attention to specific practical success factors is key.