Evaluating broad-scale system change using the Consolidated Framework for Implementation Research: challenges and
Jennifer N Hill1, Sara M Locatelli2, Barbara G Bokhour3
1Center for Evaluation of Practices and Experiences of Patient-Centered Care (CEPEP), Center of Innovation for, Complex Chronic Health Care (CINCCH), Edward Hines Jr. VA Hospital, 5000 S. 5th Ave (151H), Hines, IL, 60141, USA. jennifernhill@gmail.com.
BMC Research Notes
|August 5, 2018
Summary
This study shows how to use the Consolidated Framework for Implementation Research (CFIR) to evaluate large-scale healthcare changes. Key strategies include adapting definitions, using mixed methods, and expediting analysis for practical results.
Area of Science:
- Implementation Science
- Healthcare Management
- Health Services Research
Background:
- Evaluating broad-scale healthcare change presents unique challenges.
- The Department of Veterans Affairs (VA) is implementing Patient-Centered Care and Cultural Transformation (PCC&CT), a complex initiative.
- Understanding factors influencing PCC&CT implementation is crucial for success.
Purpose of the Study:
- To demonstrate the utility of the Consolidated Framework for Implementation Research (CFIR) for evaluating broad-scale change.
- To discuss challenges encountered during the assessment of broad-scale change.
- To present solutions developed by an evaluation team to address these challenges.
Main Methods:
- Qualitative assessment using the CFIR framework.
- Evaluation of the implementation of Patient-Centered Care and Cultural Transformation (PCC&CT) within the VA.
- Discussion of challenges and solutions in applying CFIR to a large-scale transformation.
Main Results:
- Three strategies are recommended for evaluating broad-scale change using CFIR: adapting construct definitions, employing a mixed deductive-inductive approach with thematic coding, and utilizing expedited analysis for rapid feedback.
- This research is among the first to guide the evaluation of broad-scale transformation using CFIR, rather than discrete interventions.
- The described processes and strategies offer a structured approach for others evaluating large-scale implementations.
Conclusions:
- The CFIR framework can be effectively adapted for evaluating broad-scale healthcare transformations.
- Strategies such as adapted definitions, mixed-methods analysis, and expedited synthesis are vital for successful implementation evaluations.
- The findings provide a transferable model for researchers and practitioners evaluating large-scale change initiatives in healthcare settings.
Keywords:
Consolidate framework for implementation researchEvaluationFrameworkImplementation scienceTheoryMore Related Videos
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