Ingredients for change: revisiting a conceptual framework
Open accessAbstract
Finding ways to deliver care based on the best possible evidence remains an ongoing challenge. Further theoretical developments of a conceptual framework are presented which influence the uptake of evidence into practice. A concept analysis has been conducted on the key elements of the framework--evidence, context, and facilitation--leading to refinement of the framework. While these three essential elements remain key to the process of implementation, changes have been made to their constituent sub-elements, enabling the detail of the framework to be revised. The concept analysis has shown that the relationship between the elements and sub-elements and their relative importance need to be better understood when implementing evidence based practice. Increased understanding of these relationships would help staff to plan more effective change strategies. Anecdotal reports suggest that the framework has a good level of validity. It is planned to develop it into a practical tool to aid those involved in planning, implementing, and evaluating the impact of changes in health care.
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The most successful implementation will occur when evidence is robust and practitioners agree with it, the context is receptive, and implementation processes are appropriately facilitated by internal and/or external facilitators.
“Specifically, the working proposition is that the most successful implementation will occur when evidence is robust and practitioners ‘agree’ with it, the context is receptive, and where implementation processes are appropriately facilitated by internal and/or external facilitators [13,14].”
From The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework (2013) · cites this paper as [13]
PARIHS represents the complexity of implementation by considering the three core elements and their sub-elements to be dynamic and interrelated.
“PARIHS represents the complexity of implementation by considering the three core elements and their sub-elements to be dynamic and interrelated.”
From The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework (2013) · cites this paper as [13]
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- Authors
- Rycroft-Malone, J.
- Venue
- Quality and Safety in Health Care
- Publisher
- BMJ
- Published
- 2002-06-01
- Volume
- 11
- Issue
- 2
- Pages
- 174-180
- ISSN
- 1475-3898 (ISSN-L)
- 1475-3901
- PMC
- PMC1743587
- OpenAlex
- W2171630622
- Cited by
- 701
- References
- 26
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 19 · 2023: 13 · 2022: 24 · 2021: 24 · 2020: 24 · 2019: 17 · 2018: 27 · 2017: 25 · 2016: 31 · 2015: 55 · 2014: 42 · 2013: 40 · 2012: 35
- FWCI
- 39.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ Quality & Safety (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- evidence-based practice, implementation of evidence, conceptual framework, conceptual analysis, context, facilitation, change strategies, health service improvement, evidence uptake
- MeSH terms
- Delivery of Health Care, United Kingdom, Health Plan Implementation, Health Services Research, Humans, Organizational Innovation, Practice Patterns, Physicians', Quality Assurance, Health Care, Reproducibility of Results, Organizational Culture, Patient Satisfaction, Process Assessment, Health Care, Evidence-Based Medicine
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