🩺 How do we sustain de-implementation of low-value care in paediatric bronchiolitis? Interviewing 50 ED and paediatric clinicians from 12 hospitals that took part in the PREDICT Bronchiolitis KT trial, the authors identified facilitators and barriers using the Consolidated Framework for Sustainability Constructs in Healthcare. Key messages: 🔹 A culture of evidence-based practice, supported by senior leadership, helps maintain reduced use of five low-value practices (e.g., salbutamol, steroids, chest X-ray). 🔹 Ongoing multimodal education, formal and informal, reinforces key messages and supports new staff. 🔹 Strong clinical leaders as unofficial champions promote guideline use and model best practice. 🔹 Barriers included lack of paediatric-trained ED staff, bronchiolitis no longer seen as a priority, and limited time for education. Sustaining de-implementation in acute care requires more than a one-off intervention: it needs culture, leadership and continuous education tailored to local context. 🔗 bit.ly/4oRDAj0