Deciding to End the Program
In general, programs conclude for 1 of the following 5 reasons (Eddy & Berry, 2009; Shediac–Rizkallah and Bone, 1998; Massatti et al., 2008):
- Program too costly
- Program ineffective
- An undue burden on staff capacity
- The loss of community support
- Unable to secure financial support to continue
These factors may lead to a time when the right choice for your organization and clients will be to conclude your EBP. This can happen because of changes beyond your control.
If you are considering concluding your practice, you will find that careful planning and consideration of the needs of your clients, staff, and organizational supports can ease a difficult transition.
Concluding a practice through the removal of the practice in your organization is called de-implementation. This process is to be done carefully and with the use of monitoring data and process evaluation information.
Removing an Evidence-Based Program
As you survey the scope of work being done by your organization, the addition of a new program or practice may require the removal of a current program that has run its course or has been shown to be no longer effective at meeting your goals.
In clinical settings, the removal of an existing practice is called de-implementation (Niven et al., 2015). De-implementation is a new research field, and strong evidence-based guidelines and resources do not yet exist.
To both advance efforts to research de-implementation and to provide program and agency leaders with guidance from the current literature, we created a workbook on de-implementation for behavioral health programs for the Learning Center.
The de-implementation checklist was designed to help you identify programs and practices in your organizational setting that may be hindering your ability to best serve your clients and populations.
Concluding an Evidence-Based Program
Unlike de-implementation, when a program comes to a natural end, the process is called concluding. Here, the goal is to enable a process for transitioning clients to new services, supporting them as they no longer receive services, and supporting staff.
While you are planning for the end of your program or practice, you will likely be trying to balance the needs of your clients, staff, and organizational leadership. Concluding a practice, even if it is disappointing, can be a time to increase your understanding about what may or may not work in your setting.
Being able to take a step back, looking at the information you have gathered from evaluation, monitoring, and technical assistance, and identifying your assets can enable you and your team to work toward implementing your next program with success.
In addition to engaging in processes where you review your tracking and outcomes data to assist you with your next program, you may also want to focus on communicating about the successes that you achieved during implementation. The CDC has compiled a checklist and guide for sharing lessons learned through evaluation of a program.