Join together, intentionally coordinating and collaborating on interdependent tasks, to implement the innovation.

Researchers have noted the important influence of team capabilities, social relationships, teamwork, and morale in accomplishing their goals (see also Implementation Team Members and Characteristics) (Chan et al., 2011; A. L. Parker et al., 2019; L. Rogers et al., 2020; Sarkies et al., 2020; Spitzer-Shohat et al., 2018), which are encapsulated within Edmondson’s concept of teaming (Edmondson, 2012). Working with teams, rather than relying a “hero-model” where motivated individuals do all or most of the work, is an important ingredient for sustained change (Doyle et al., 2013; Edmondson, 2012; Miake-Lye et al., 2020). Edmondson describes levels of maturity in teaming: 1) the need for teaming is recognized; 2) individuals communicate; 3) steps and hand-offs are coordinated; 4) reciprocal and interdependent action unfolds; 4) teams take time and space to reflect; 5) teaming mindset in psychologically safe spaces is adopted (Edmondson, 2012).

Strategies to build coalitions and conduct local consensus discussions (key activities in teaming) are among the most frequently recommended strategies to address implementation barriers (Waltz et al., 2019). The original CFIR asserted that any one role cannot function in isolation; relationships between individuals can be more important than individual roles or individual characteristics (Plsek & Wilson, 2001).

Qualitative coding guidelines that are aligned with the Updated CFIR will be added in the future.

As we become aware of measures, we will post them here. Please contact us with updates.

Chan, K. S., Hsu, Y.-J., Lubomski, L. H., & Marsteller, J. A. (2011). Validity and usefulness of members reports of implementation progress in a quality improvement initiative: Findings from the Team Check-up Tool (TCT). Implementation Science, 6(1), 115.

Edmondson, A. C. (2012). Teaming: How organizations learn, innovate, and compete in the knowledge economy. Jossey-Bass.

Parker, A. L., Forsythe, L. L., & Kohlmorgen, I. K. (2019). TeamSTEPPS®: An evidence‐based approach to reduce clinical errors threatening safety in outpatient settings: An integrative review. Journal of Healthcare Risk Management, 38(4), 19–31.

Plsek, P. E., & Wilson, T. (2001). Complexity, leadership, and management in healthcare organisations. Bmj, 323(7315), 746–749.

Rogers, L., De Brún, A., & McAuliffe, E. (2020). Defining and assessing context in healthcare implementation studies: A systematic review. BMC Health Services Research, 20(1), 591.

Sarkies, M., Long, J. C., Pomare, C., Wu, W., Clay-Williams, R., Nguyen, H. M., Francis-Auton, E., Westbrook, J., Levesque, J.-F., Watson, D. E., & Braithwaite, J. (2020). Avoiding unnecessary hospitalisation for patients with chronic conditions: A systematic review of implementation determinants for hospital avoidance programmes. Implementation Science, 15(1), 91.

Spitzer-Shohat, S., Shadmi, E., Goldfracht, M., Key, C., Hoshen, M., & Balicer, R. D. (2018). Evaluating an organization-wide disparity reduction program: Understanding what works for whom and why. PLOS ONE, 13(3), e0193179.

Waltz, T. J., Powell, B. J., Fernández, M. E., Abadie, B., & Damschroder, L. J. (2019). Choosing implementation strategies to address contextual barriers: Diversity in recommendations and future directions. Implementation Science, 14(1), 42.