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Perception of key stakeholders about whether the intervention is externally or internally developed.
Perception of key stakeholders about whether the intervention is externally or internally developed . An intervention may be internally developed as a good idea, solution to a problem, or other grass-roots effort, or may be developed by an external entity (e.g., vendor or research group) . The legitimacy of the source may also influence implementation.
Rationale for inclusion
Perception of key stakeholders about whether the intervention is externally or internally developed may influence success of implementation. The intervention may enter into the organization through an external source such as a formal research entity or vendor (see also, External Policy & Incentives under Outer Setting). Alternatively, an intervention may have been internally developed as a good idea, solution to a problem, or other grass-roots effort.
An externally developed intervention coupled with lack of transparency in the decision-making process may lead to implementation failure. Dissemination, “whose main mechanism of spread is centrally driven and controlled” is negatively associated with implementation (, page 604; emphasis added). Though there is empirical evidence of a positive association with an authoritative decision to use the intervention, there is a negative relationship with fully implementing or routinizing the intervention. On the other hand, key ideas that come from outside the organization and that are then effectively tailored to the organization can result in successful implementation (See Adaptability). Sometimes, internal decisions to adopt or implement an intervention may be perceived as externally driven. If the decision to adopt and implement is made by leaders higher in the hierarchy who edict change with little user input in the decision to implement an intervention, implementation is less likely to be effective.
Qualitative codebook guidelines
Include statements about the source of the innovation and the extent to which interviewees viewed the change as internal to the organization, e.g., an internally developed program, or external to the organization, e.g., a program coming from the outside. Note: May code and rate as "I" for internal or "E" for external.
- External Source: “Wow. Well there’s nothing like an unfunded mandate you know to get ... their blood boiling around here where workloads are so high.”
- Internal Source: “We all got together and decided that we wanted to participate in the study that an outside research team was doing.”
Exclude or double code statements related to who participated in the decision process to implement the innovation to Engaging, as an indication of early (or late) engagement. Participation in decision-making is an effective engagement strategy to help people feel ownership of the innovation.
- ↑ 1.0 1.1 1.2 1.3 1.4 Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004, 82:581-629.
- ↑ Van de Ven AH, Polley DE, Garud R, Vandataraman S: The Innovation Journey. Oxford: Oxford University Press; 1999.
- ↑ Kitson A, Harvey G, McCormack B: Enabling the implementation of evidence based practice: a conceptual framework. Qual Health Care 1998, 7:149-158.
- ↑ Rycroft-Malone J, A., Kitson G, Harvey B, McCormack K, Seers AT, Estabrooks C: Ingredients for change: revisiting a conceptual framework. (Viewpoint). Quality and Safety in Health Care 2002, 11:174-180.
- ↑ Gustafson DH, Sainfort F, Eichler M, Adams L, Bisognano M, Steudel H: Developing and testing a model to predict outcomes of organizational change. Health Serv Res 2003, 38:751-776.
- ↑ Klein KJ, Conn AB, Sorra JS: Implementing computerized technology: An organizational analysis. J Appl Psychol 2001, 86:811-824.
- ↑ Helfrich CD, Weiner BJ, McKinney MM, Minasian L: Determinants of implementation effectiveness: adapting a framework for complex innovations. Med Care Res Rev 2007, 64:279-303.