The Framework
The Innovation: The proposed new model for delivering healthcare.
Factors influencing implementation:These domains are factors that drive and facilitate the implementation of a new model of care. Just like how a handle turns a key, these factors are essential for enabling effective implementation.
Outcomes:Capture the value or effectiveness of the new models of care, aligning with the evaluation domains.
This addresses key questions:Did the implementation occur effectively? (Implementation outcomes) Were the objectives met? (Innovation outcomes) The guide comprises six main domains, each containing its own subset of factors that impact implementation.
The Framework
This framework is designed to help teams understand the contextual and individual factors that influence the implementation and evaluation of new models of care.
Broadly the components are:
The Innovation: The proposed new model for delivering healthcare or addressing an identified need.
Factors influencing implementation: There are five domains (innovation characteristics, external factors, internal factors, people and implementation process) within the framework that drive and facilitate the implementation of a new model of care. Just like how a handle turns a key, these factors are essential for enabling effective implementation.
Outcomes: These measure the success and impact of the new care models, matching with the evaluation areas. They help answer important questions; Was the implementation successful? (Implementation outcomes) Were the goals achieved? (Innovation outcomes: effectiveness, safety, patient-centeredness, healthcare professional experiences, accessibility, service delivery, and economic evaluation)
Discover more about the factors that affect the implementation of new models of care and the
considerations for evaluation in the section below or by clicking on the infographic.
Innovation Characteristics
The innovation characteristics domain explores the distinguishing features that set a new idea or alternative model of care apart from current practices or interventions. There are a variety of characteristics that shape its effectiveness and suitability.
Key Attributes of Innovation
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- Evidence Base: The degree to which the innovation is supported by empirical research, clinical trials, or best practice guidelines. This serves as a foundation for assessing its reliability and potential impact.
- Support and Endorsement: The endorsement and backing the innovation receives from key stakeholders, including professional organisations, policymakers, or opinion leaders. This endorsement signifies confidence in its value and relevance.
- Advantages: These are the perceived benefits or strengths of the innovation, including factors like accessibility, effectiveness, safety, cost-effectiveness, and benefits to stakeholders. Understanding these advantages sheds light on the potential value it brings to healthcare.
- Disadvantages or Uncertainties: Potential drawbacks or limitations of the innovation, such as risks, implementation challenges, or unintended consequences. Identifying these uncertainties allows for proactive management and informed decision-making.
Understanding these attributes is crucial for assessing the innovation's compatibility with current practices and its potential to address healthcare needs effectively. It provides insights into the feasibility, acceptability, and sustainability of implementing the innovation in a specific context.
External Factors
The external factors domain investigates factors that shape the adoption of innovations. These factors are crucial for understanding the broader environment in which implementation occurs.
Key Factors to Consider
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- Partnership and Connection Networks: The collaborative relationships and networks with external organisations, stakeholders, and community resources that can either support or hinder implementation efforts.
- Policies and Laws: The impact of legislative and regulatory frameworks on healthcare practices. Policies and laws influence decisions related to reimbursement, quality standards, and legal requirements.
- Financing: Financial incentives, reimbursement models, and funding sources that impact the availability of resources for implementation and sustainability of innovations.
- Performance Management Pressure: The role of performance metrics and targets in shaping organisational priorities. Pressure to meet performance goals can influence decision-making regarding innovation adoption.
Recognising these external influences, stakeholders can better navigate the implementation process and develop strategies for successful innovation adoption. Understanding the Outer Setting factors is key to overcoming challenges and leveraging opportunities in when implementing a new idea or model of care.
Internal Factors
In this domain, we delve into how the local organisational context influences the implementation process. Various factors within the organisational environment play pivotal roles in shaping implementation efforts of new ideas or models of care.
Key Phases of the Implementation Process
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- Work Infrastructure: This considers the physical and organisational infrastructure that supports daily operations. Adequate work infrastructure facilitates smooth implementation processes.
- Relational Connections: These are the relationships and connections among team members and stakeholders. Strong relational connections foster collaboration and teamwork essential for successful implementation.
- Communication: This considers the effectiveness of communication channels within the organisation. Clear and open communication promotes transparency and ensures all stakeholders are informed and engaged.
- Organisational Culture: This examines the prevailing values, beliefs, and norms within the organisation. Organisational culture shapes attitudes and behaviours, influencing how innovations are received and adopted.
- Mission Alignment: This evaluates the alignment of implementation efforts with the organisation's mission and goals. When implementation aligns with the broader mission, it enhances organisational commitment and support.
- Available Resources: This considers the availability of human, financial, and technological resources to support implementation activities for the new idea or model of care. Adequate resources are essential for overcoming implementation challenges and sustaining innovation adoption.
- Access to Knowledge: Assess the accessibility and dissemination of knowledge and information to implement the new idea or model of care within the organisation. Access to relevant knowledge enhances decision-making and fosters innovation adoption.
Understanding and leveraging these internal dynamics are critical for successful integration of innovations within the organisational context. By recognising the influence of these factors, stakeholders can develop strategies to overcome barriers and promote the effective implementation of innovations.
People
In this domain, we focus on the individuals involved in the implementation process. Stakeholders at various levels play crucial roles in driving effective implementation efforts.
Key Stakeholder Groups
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- High-Level Leaders: Individuals in the executive or senior management level who provide overarching vision, direction, and support for implementation efforts.
- Mid-Level Leaders: Managers and supervisors who oversee specific departments or units and play a pivotal role in translating organisational goals into actionable plans.
- Opinion Leaders: Influential individuals within the organisation whose opinions and actions sway the attitudes and behaviours of others, often serving as champions for innovation adoption.
- Implementation Facilitators: Subject matter experts or consultants who provide guidance, support, and resources to facilitate the implementation process.
- Implementation Leads and Deliverers: Individuals responsible for leading and executing specific aspects of the implementation plan, driving day-to-day activities and progress.
- Implementation Support/Team Members: Team members who contribute to the implementation process by providing additional support, expertise, and assistance in various capacities. e.g., data collection, clinic set up training, troubleshooting.
- Innovation Recipients: End users or beneficiaries of the innovation, including patients, clients, or other stakeholders who experience the direct impact of the new practices or interventions.
Recognising the perspectives of these stakeholder groups, addressing their concerns, and fostering their engagement are key strategies for driving effective implementation. By involving stakeholders at every stage of the process, organisations can maximize buy-in, promote collaboration, and enhance the likelihood of successful innovation adoption.
Implementation Process
This domain explores the steps and strategies involved in getting a new idea or model of care up and running effectively within an organisation. A structured implementation process is essential for translating ideas into action and achieving desired outcomes.
Key Phases of the Implementation Process
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- Planning: The development of a comprehensive plan outlining the goals, strategies, resources, and timelines required for implementation. Effective planning sets the foundation for a successful rollout.
- Engaging: The process of involving stakeholders at all levels, including leadership, staff, and end users, to foster buy-in and support. Engagement ensures that everyone is informed, motivated, and committed to the implementation effort.
- Doing: The execution of the implementation plan by integrating the innovation into practice. This phase involves coordinating activities, managing resources, and addressing any issues that arise during the rollout.
- Reflect and Evaluate: The continuous monitoring and assessment of the implementation process to identify successes and areas for improvement. Collecting and analysing data helps to understand the impact of the innovation and make informed adjustments.
- Adapting: The process of making necessary adjustments based on feedback and evaluation findings. Adapting the implementation approach ensures that the innovation remains effective and sustainable over time.
A well-structured implementation process is vital for ensuring that innovations are effectively integrated into organisational practices. By following these key phases, organisations can achieve successful outcomes and sustain improvements over time.
Outcomes and Performance
The Outcomes domain examines the end results of implementing an innovation. This includes various aspects that determine the overall impact and sustainability of the innovation.
Key Outcomes
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Implementation Outcomes
- Adoptability: The ease with which the innovation can be adopted by users and integrated into existing practices.
- Implementability: The practicality and feasibility of implementing the innovation within the organisational context.
- Sustainability: The ability of the innovation to be maintained over time without diminishing effectiveness.
Innovation Outcomes
- Effectiveness: The degree to which the innovation achieves its intended goals and produces desired health outcomes.
- Safety: The extent to which the innovation avoids causing harm to patients and contributes to their overall safety.
- Patient-Centeredness: The focus on providing care that respects and responds to individual patient preferences, needs, and values.
- Healthcare Professional/System Experience: The impact of the innovation on the experiences and satisfaction of healthcare professionals and the overall healthcare system.
- Accessibility: The extent to which the innovation is available and usable by all who need it, ensuring equitable access to care.
- Service Delivery: The efficiency and effectiveness of healthcare services provided as a result of implementing the innovation.
- Economic Evaluation: The analysis of the cost-effectiveness and financial impact of the innovation, including potential savings and resource utilization.
Evaluating these outcomes provides comprehensive insights into the innovation’s performance, highlighting areas of success and opportunities for improvement. This evaluation is crucial for understanding the overall impact and sustainability of the innovation, informing future efforts and guiding continuous improvement.
