Performance-Measurement Pressure

Quality or benchmarking metrics or established service goals drive implementation and/or delivery of the innovation.

Performance measurement can influence implementation and/or delivery of the innovation (Mendel et al., 2008). This construct includes formal mechanisms of performance accountability, audit and feedback, outcome goals (Raghavan et al., 2008), benchmarking (Nilsen & Bernhardsson, 2019), and public reporting (Nilsen & Bernhardsson, 2019).

The original CFIR elaborated further on this construct, stating that the threat or reality of public reporting may motivate Inner Settings, especially late-adopters, to implement an innovation in an effort not to look bad compared to their competitors (see Market Pressure). However, public reporting can also have a negative influence if there is an adversarial relationship between the reporting entity and the Inner Setting. In this context, people may cover-up (compliant implementation) (Klein & Sorra, 1996) or engage in “box-checking” rather than true committed use.

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.

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

Mendel, P., Meredith, L. S., Schoenbaum, M., Sherbourne, C. D., & Wells, K. B. (2008). Interventions in organizational and community context: A framework for building evidence on dissemination and implementation in health services research. Adm Policy Ment Health, 35(1–2), 21–37.

Nilsen, P., & Bernhardsson, S. (2019). Context matters in implementation science: A scoping review of determinant frameworks that describe contextual determinants for implementation outcomes. BMC Health Services Research, 19(1), 189.

Raghavan, R., Bright, C. L., & Shadoin, A. L. (2008). Toward a policy ecology of implementation of evidence-based practices in public mental health settings. Implementation Science, 3(1), 26.