Relative Priority

The original CFIR elaborated on this construct, stating that the importance of implementing and delivering the innovation relative to other initiatives can affect implementation outcomes.(Feldstein & Glasgow, 2008; Klein et al., 2001; Klein & Sorra, 1996). If employees perceive that implementation is a key organizational priority (promoted, supported, and cooperative behaviors rewarded), then implementation climate will be strong (Klein et al., 2001). When relative priority is high, employees regard the innovation as an important priority rather than a distraction from their “real work” (Klein et al., 2001). The higher the relative priority of implementing an innovation, the more effective the implementation is likely to be (Helfrich, Weiner, et al., 2007; Klein et al., 2001). The ability of an organization to fully implement may be a function of how many other initiatives or changes have been rolled out in the recent past, which may lead to being overwhelmed with yet another implementation (Greenhalgh, Robert, et al., 2004; Gustafson et al., 2003); as a consequence, implementation may become a low priority.

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

Inclusion Criteria

Include statements that reflect the relative priority of the innovation e.g., due to the implementation of many other programs.

• “We have so many studies going on that I feel like this just doesn’t get the attention it needs. We are all too overwhelmed.”
• “It’s really important for us to get this done because it will affect our performance measures.”

Exclusion Criteria

Exclude or double code statements regarding the priority of the innovation based on compatibility to Compatibility e.g., if an innovation is not prioritized because it is not compatible with work processes.

Regarding quantitative measurement of this construct: In a systematic review of quantitative measures related to implementation, Powell et al. identified two measures (Powell et al., 2021). Using PAPERS criteria of measurement quality with an aggregate scale ranging from -9 to +36 (Lewis, Mettert, Stanick, et al., 2021), the two measures had scores of -1 and 3. Results indicate the need for continued development of high-quality measures.

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

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.

Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Q, 82(4), 581–629.

Gustafson, D. H., Sainfort, F., Eichler, M., Adams, L., Bisognano, M., & Steudel, H. (2003). Developing and testing a model to predict outcomes of organizational change. Health Serv Res, 38(2), 751–776.

Helfrich, C. D., Weiner, B. J., McKinney, M. M., & Minasian, L. (2007). Determinants of implementation effectiveness: Adapting a framework for complex innovations. Med Care Res Rev, 64(3), 279–303.

Klein, K. J., Conn, A. B., & Sorra, J. S. (2001). Implementing computerized technology: An organizational analysis. Journal of Applied Psychology, 86(5), 811–824.

Klein, K. J., & Sorra, J. S. (1996). The Challenge of Innovation Implementation. The Academy of Management Review, 21(4), 1055–1080.

Lewis, C. C., Mettert, K. D., Stanick, C. F., Halko, H. M., Nolen, E. A., Powell, B. J., & Weiner, B. J. (2021). The psychometric and pragmatic evidence rating scale (PAPERS) for measure development and evaluation. Implementation Research and Practice, 2, 263348952110373. https://doi.org/10.1177/26334895211037391.

Powell, B. J., Mettert, K. D., Dorsey, C. N., Weiner, B. J., Stanick, C. F., Lengnick-Hall, R., Ehrhart, M. G., Aarons, G. A., Barwick, M. A., Damschroder, L. J., & Lewis, C. C. (2021). Measures of organizational culture, organizational climate, and implementation climate in behavioral health: A systematic review. Implementation Research and Practice, 2, 263348952110188. https://doi.org/10.1177/26334895211018862.