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Table 1 CFIR constructs and sample interview questions

From: Evaluating broad-scale system change using the Consolidated Framework for Implementation Research: challenges and strategies to overcome them

Construct

Rationale for Selection

Sample questions

Domain: intervention characteristics

 Intervention source

[Evaluation team]

The intervention was ongoing, evaluation team wanted to capture historical information

Can you tell me a bit about the history of transforming the organization to patient-centered care?

 Evidence strength and quality

[Evaluation team]

Collect information on perceptions of evidence regarding PCC

What clinical or research evidence, or literature were you aware of that supported use of an intervention like this?

 Relative advantage

[Evaluation team]

Advantages and goals of transformation and expectations of practice

What is your understanding of the goals of this initiative? How is this different from what you were doing?

 Adaptability

[Evaluation team]

Document adaptations, especially given the broad scope of the transformation

What were challenges you encountered? What adaptations were made to overcome these challenges?

 Complexity

[Evaluation team]

Gather information on perceived complexity of the PCC cultural transformation

How difficult would you say it has been to implement the intervention?

 Cost

[Evaluation team]

Funding available from OPCC&CT and money contributed by facility

What types of funding have you received since becoming a COI to implement PCC innovation(s)? Did your facility incur any additional costs not covered by the funds?

Domain: outer setting

 Patient needs and resources

[OPCC&CT and evaluation team]

Level of patient involvement in the transformation

How are interventions selected? How do patients become engaged? What feedback is collected from them?

Domain: inner setting

 Implementation climate\culture

[OPCC&CT and evaluation team]

Receptivity to the transformation

What was your perception of staff attitudes about the patient-centered care changes?

 Tension for change

[Evaluation team]

Is/was there a perceived need for change present?

What was your perception of the need for change?

 Relative priority

[OPCC&CT and evaluation team]

Level of priority of transformation in the real-world, clinical setting

Compared to other demands in the organization, how much of a priority is PCC?

 Organizational incentives\rewards

[Evaluation team]

Feedback received from OPCC&CT and individual/facility-level

How is feedback provided to staff on progress toward goals?

 Goals and feedback

[OPCC&CT and evaluation team]

Process for selecting and setting facility goals

How are goals communicated to staff? How is progress evaluated?

 Leadership engagement

[OPCC&CT and evaluation team]

Level of leadership involvement and activities contributing to transformation

What level of involvement did leadership have with this initiative? What did they do?

 Available resources

[OPCC&CT and evaluation team]

Resources provided by OPCC&CT and those provided by facility leadership

To what extent are there additional resources available to support these efforts?

Domain: characteristics of the individual

 Knowledge and beliefs

[OPCC&CT and evaluation team]

Impact of messaging about PCC on how it’s defined at the individual-level

What do you think about when you hear the term patient-centered care? What are its key aspects?

Domain: process

 Planning

[OPCC&CT and evaluation team]

Identify process and selection of assembly of local implementation team

Once the decision was made to start this initiative, who was involved in planning?

 Engaging: staff

[OPCC&CT and evaluation team]

How and why staff are engaged in the PCC cultural transformation

How were staff members engaged to participate in the initiative? Training provided?

 Engaging: champions

[OPCC&CT and evaluation team]

If/how champions emerged—who, what, why

Who was involved in planning? Was there a particular person who led the charge? How does this person’s energy for this initiative affect ongoing efforts?

 Executing

[OPCC&CT and evaluation team]

Identify spread/touch of PCC to patients

How do you document that a patient has been recommended\ participated in a PCC innovation?

 Reflecting and evaluating

[OPCC&CT and evaluation team]

Site-level processes for tracking transformation progress

What is being done to evaluate implementation of the intervention? Patient outcomes?