Opportunity

Michie et al. broadly define opportunity as “all the factors that lie outside the individual that make the behavior possible or prompt it” (Michie et al., 2011). In the updated CFIR, themes related to this construct are specific to implementing and delivering an innovation in the Inner Setting, including staff availability and sufficient time allocation, autonomy, and control to fulfill the role (Ashok et al., 2018; Dy et al., 2015; Means et al., 2020; Moretto et al., 2019). The quality of support provided by the Inner Setting to individuals is positively associated with implementation (Ovretveit, 2002).

The original CFIR provided further elaboration on this construct. Allocation of time by the organization is a key component of Opportunity; individuals involved in implementation will be more effective if they have dedicated time rather than as a distraction on top of other job duties (Feldstein & Glasgow, 2008). Implementation will be more effective when key individuals dedicate time and energy and are empowered and supported by their organization in their efforts to implement and deliver the innovation (Brach et al., 2008; Feldstein & Glasgow, 2008; Fixsen, 2007). However, Inner Settings may have “slack resources” (see also Inner Setting: Work Infrastructure) that enables people to “squeeze” time on top of their regular duties, to implement the innovation without noticeable unintended impacts. Ideally, leaders empower Innovation Deliverers and Implementation Leads and Teams by providing autonomy from rules, procedures, and systems of the organization so they can establish creative solutions to existing problems and generate support from other members of the organization.

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.

Ashok, M., Hung, D., Rojas-Smith, L., Halpern, M. T., & Harrison, M. (2018). Framework for Research on Implementation of Process Redesigns: Quality Management in Health Care, 27(1), 17–23. https://doi.org/10.1097/QMH.0000000000000158.

Brach, C., N. Lenfestey, A. Roussel, J. Amoozegar, & A. Sorensen. (2008). Will It Work Here? A Decisionmaker’s Guide to Adopting Innovations. Agency for Healthcare Research & Quality (AHRQ). https://www.ahrq.gov/innovations/will-work/index.html.

Dy, S. M., Ashok, M., Wines, R. C., & Rojas Smith, L. (2015). A Framework to Guide Implementation Research for Care Transitions Interventions: Journal for Healthcare Quality, 37(1), 41–54. https://doi.org/10.1097/01.JHQ.0000460121.06309.f9.

Feldstein, A. C., & Glasgow, R. E. (2008). A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Jt Comm J Qual Patient Saf, 34(4), 228–243.

Fixsen, D. L. (2007). Implementation Research: A Synthesis of the Literature. University of South Florida, Louis de la Parte Florida Mental Health Institute.

Means, A. R., Kemp, C. G., Gwayi-Chore, M.-C., Gimbel, S., Soi, C., Sherr, K., Wagenaar, B. H., Wasserheit, J. N., & Weiner, B. J. (2020). Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: A systematic review. Implementation Science, 15(1), 1–19. https://doi.org/10.1001/jamasurg.2017.5565.

Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science : IS, 6, 42. https://doi.org/10.1186/1748-5908-6-42.

Moretto, N., Comans, T. A., Chang, A. T., O’Leary, S. P., Osborne, S., Carter, H. E., Smith, D., Cavanagh, T., Blond, D., & Raymer, M. (2019). Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services. Implementation Science, 14(1), 78. https://doi.org/10.1186/s13012-019-0923-1.

Ovretveit, J. (2002). Quality collaboratives: Lessons from research. Quality and Safety in Health Care, 11(4), 345–351. https://doi.org/10.1136/qhc.11.4.345.