Consolidated Framework for Implementation Research
QUERI Guide to Implementation Research The Quality Enhancement Research Initiative (QUERI) has created an extensive guide for implementation research. The guide is a resource for selection of theory, methods and formative evaluation type. It also contains links to tools and toolkits that researchers may find useful.
The CFIR isn’t a prescriptive framework, meaning that it does not prescribe specific steps to take to implement a new innovation. Instead, it provides a broad taxonomy of factors that influence implementation. Many proscriptive theories and frameworks have been published that describe sequenced or interrelated activities to accomplish successful implementation. Below is a list of a few resources and prescriptive models/frameworks.
Active Implementation (AI) Hub : The AI Hub is a free, online learning environment geared toward anyone involved in active implementation or scaling up of programs and innovations. The site’s goal is to increase the knowledge and improve the performance of individuals engaged in actively implementing an innovation. They provide many helpful tutorials, tools and forums that provide in depth information on the process of implementation.
Getting to Outcomes (GTO) : The GTO provides a model for carrying out implementation and support aimed at enhancing implementers' capacity. The GTO model describes ten steps for successful implementation. The Quality Implementation Framework provides an update to this body of research.
Institute for Healthcare Improvement (IHI) Breakthrough Process : IHI’s Innovation Series white papers were developed to further their mission of improving the quality and value of health care. The findings and tools in these reports provide readers with an opportunity to understand and evaluate the issues, and begin testing changes that can help your organization make breakthrough improvements.
Recommendations for evaluation of health care improvement initiatives : In this paper, the authors argue for formative-theory driven evaluation of implementations that is iterative in nature and is changed to quickly reflect the realities of an implementation environment. The cyclical feedback loop advocated here can be categorized as evaluation of strategies and phases of improvements.
Stages of Implementation Completion (SIC) : This body of research describes and tests approaches to predict program start-up using the stages of implementation measure; the Stages of Implementation Completion (SIC) was developed as part of an implementation trial in 53 sites. It is unique in identifying the amount of time spent on each implementation activity and the proportion of activities completed. The results of this paper suggest that completing the first three stages of the SIC (Engagement, Consideration of Feasibility, Readiness Planning) relatively quickly is a strong predictor of successful implementation.
The Seattle Implementation Research Conference's Measures Project is in the process of identifying measurement instruments and mapping them to the CFIR and an outcomes framework; over 400 instruments have been identified and the SIRC is in the process of evaluating each instrument. Check back regularly for updates.
There are a number of training resources available for those interested in delving more deeply into implementation theory. Below is a list of materials and events. These events are offered as a resource. All are supported by non-profit funding (e.g., NIH grants) that are dedicated to building capacity and advancing the science of implementation. If you know of any training resources, please let us know and we will post as appropriate.
Training Institute for Dissemination and Implementation Research in Health (TIDIRH) : The TIDIRH holds yearly conference dedicated to dissemination and implementation. It is run by Harvard University and the Dana-Farber Cancer Institute, with support from the NIH.
Implementation of Evidence Based Practices from Evidence Based Behavioral Practice : They compile resources and create training resources to bridge the gap between research and practice.