External Pressure

External pressures drive implementation and/or delivery of the innovation. Note: Use this construct to capture themes related to External Pressures that are not included in the subconstructs below.

There is strong direct evidence that the pressure to adopt an innovation, independent of perceptions of whether recipients need it or in response to a perceived problem, influences adoption and implementation, particularly in settings with strong external connections (see Partnerships and Connections) (Greenhalgh, Robert, et al., 2004). External pressure may emanate from multiple entities in the Outer Setting (Dy et al., 2015), including the subconstructs below.

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.

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

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.