There are shared values, beliefs, and norms around caring, supporting, and addressing the needs and welfare of deliverers.

Deliverer-Centeredness captures the importance of addressing the needs of deliverers, and aligns with the expansion of the “Triple Aim” (Berwick et al., 2008) (enhancing patient experience, improving population health, reducing costs) to the “Quadruple Aim,” which adds an aim to improve the work-life and well-being of clinicians and staff (Bodenheimer & Sinsky, 2014). There is an extensive literature on the important role of employee well-being (Bakker, 2015; Ilies et al., 2015). Physician burnout and personal-well-being have a potentially bi-directional or reinforcing relationship with capacity for change (Goldberg et al., 2021; Rotenstein & Johnson, 2020; Williams et al., 2018). An Agency for Healthcare Research and Quality innovation adoption guide includes questions about potential workplace inequities as potential barriers to implementation (Brach et al., 2008). The organizational social context measure, developed by Glisson et al., includes constructs related to psychological climate (perception of the psychological influence of work environment) as potential influences on implementation outcomes.

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.

Bakker, A. B. (2015). Towards a multilevel approach of employee well-being. European Journal of Work and Organizational Psychology, 24(6), 839–843.

Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The Triple Aim: Care, Health, And Cost. Health Affairs, 27(3), 759–769.

Bodenheimer, T., & Sinsky, C. (2014). From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. The Annals of Family Medicine, 12(6), 573–576.

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).

Goldberg, D. G., Soylu, T. G., Kitsantas, P., Grady, V. M., Elward, K., & Nichols, L. M. (2021). Burnout among Primary Care Providers and Staff: Evaluating the Association with Practice Adaptive Reserve and Individual Behaviors. Journal of General Internal Medicine, 36(5), 1222–1228.

Ilies, R., Aw, S. S. Y., & Pluut, H. (2015). Intraindividual models of employee well-being: What have we learned and where do we go from here? European Journal of Work and Organizational Psychology, 24(6), 827–838.

Rotenstein, L. S., & Johnson, A. K. (2020). Taking Back Control—Can Quality Improvement Enhance The Physician Experience? Health Affairs Blog.

Williams, N. J., Ehrhart, M. G., Aarons, G. A., Marcus, S. C., & Beidas, R. S. (2018). Linking molar organizational climate and strategic implementation climate to clinicians’ use of evidence-based psychotherapy techniques: Cross-sectional and lagged analyses from a 2-year observational study. Implementation Science, 13(1), 85.