Though less attention has been paid historically to the need for group and personal reflection, more recent literature is acknowledging its key role in strong teaming and team-building (Edmondson 2012). Dedicating time for reflecting or debriefing before, during, and after implementation is one way to promote shared learning and improvements (Edmondson et al. 2001). The original CFIR (Damschroder, Aron, et al. 2009) asserted that these times of reflection help foster a learning climate – one in which a successful implementation can be ingrained into institutional memory and help improve the odds for future implementations (Edmondson et al. 2001; Simpson and Dansereau 2007). Even failures, when reflected upon in an effective way, can lead to future success when the root causes are uncovered with psychological safety (Klein and Sorra 1996); failure is key for strengthening learning within organizations (Lapré and Nembhard 2011).
Timely availability of data for monitoring, evaluation, and process improvement is important (Dy et al. 2015). The original CFIR (Damschroder, Aron, et al. 2009) highlighted that data to support Reflecting and Evaluating includes quantitative and qualitative feedback about the experience, progress, and quality of implementation efforts. Evaluation includes traditional forms of feedback, such as reports and graphs, as well as qualitative feedback and anecdotal stories of success (US DHHS-National Cancer Institute 2005). Feedback on progress toward those goals or objectives is a key behavior change technique in many individual behavior change theories and models (Carey et al. 2018; US DHHS-National Cancer Institute 2005) and has strong to moderate evidence supporting implementation at an organizational level (Greenhalgh, Robert, et al. 2004). One review found that effects of using audit and feedback mechanisms to improve practices can lead to small to moderate effects (Jamtvedt et al. 2006), a finding confirmed by a more recent review (Ivers et al. 2012). It is hard for people to continue the work without sufficient feedback that is tightly coupled to goals that are important to them (Hysong et al. 2006). Reviewing progress toward goals allows people to assess whether the innovation is creating value (Jamtvedt et al. 2006).