Consolidated Framework for Implementation Research

Design an Implementation Strategy

process diagram

An evidence base is not yet established for how to tailor implementation strategies. This section describes a few ideas for developing interim tools and the needed evidence base. Please refer to our glossary for language about implementation in this section.

You are in the right place if you:

  1. Have completed an assessment to identify the constructs that may be barriers (or facilitators) for implementing an innovation into your setting
  2. Intend to implement an innovation into one or many settings and need guidance in selecting techniques to bundle into an implementation strategy tailored to your project.

The CFIR for Implementation Strategies

The CFIR describes four constructs related to the Process of implementation: Planning, Engaging, Executing, and Reflecting and Evaluating. Successful implementation relies on iterative, interacting activities related to these four constructs.

Most prescriptive frameworks and models include some form of these four constructs; though there is variation depending on the framework or model. These four CFIR constructs provide guidance for evaluating the nature and quality of implementation as it unfolds. As CFIR does not provide a step-by-step guide for how to implement innovations into organizations, we do provide links to a few published prescriptive frameworks and models that do provide such guidance (see Additional Resources).

Resources to Help Guide Implementation Strategy Development

Insights from published studies

The Cochrane Collaboration provides evidence syntheses for a wide range of techniques and strategies that may be appropriate for implementation. McMaster University’s Health Systems Evidence site (registration is free) is another source of a wide range of syntheses of research evidence; for example, a recent review was posted on the effectiveness of safety checklists.

Published articles using the CFIR may provide detailed information about how techniques or strategies may act on or through specific CFIR constructs. Using Zotero, we have created a Zotero library of CFIR citations and categorized them according to type of research and use. If you are not able to access Zotero, click here for a list of citations organized by type of research.

Idea for the Future: Select Techniques based on Barriers & Facilitators

The ERIC project has developed a list of 73 discrete evidence-based implementation techniques. We plan to create a tool to help you select techniques based on the constructs you have identified as barriers or facilitators to implementation. This project will map ERIC techniques to CFIR constructs based on expert recommendations. For example, if an assessment found Goals & Feedback to be a potential barrier, then a robust “audit and provide feedback” technique could be appropriate to help address this potential barrier. We have drafted an example of how we imagine a tool like this might work.

Idea for the Future: Learning from Others

We are planning to design a repository of study findings that used or could be mapped to CFIR constructs and provide sufficient operational detail. We have developed a few ideas on how we could utilize this type of information. We will use your feedback to guide future developments.