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Table 2 Relationships between Pettigrew et al. framework and data collection approaches [13, 17, 51]

From: Improving quality of care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change

"Pettigrew" Essential Dimensions/Questions Signs and Symptoms/Characteristics of Receptive Contexts Data Collection Approaches/Tools (Across Characteristics) Level of participants Specific Question Examples (Will always explore both targeted or single EBP change and broad EBP change across a case's timeline)**
WHY (Context, relative to motivation for strategic change toward EBP):
Why do nursing departments/directorates, and their embedded levels, wish to/implement EBP?
• Environmental pressure
• Supportive organizational culture
• Key people leading change
1. Individual Interviews & Focus groups:
a. Motivation
b. Driving or restraining forces
2. Surveys
a. Goh's Org. [58] Learning Survey
b. MLQ Leadership Tool [59]
c. NWI [60]
3. Document Review
1. Unit leaders
2. Unit staff
3. Hospital leadership
4. Relevant project or committee staff
1. What was the motivation for change:
Why did unit/hospital wish to implement EBP (specific project; general approach)?
2. What enabling/driving or restraining/hindering forces over time influenced that motivation (internal and external environment)?
WHAT (Content, relative to organizational elements or processes in the system changed to enhance or support the use of evidence):
What changes are made relative to key contextual elements to enable implementation and/or routine EBP?
• Quality and coherence of policy, e.g., alignment/infrastructure
• Managerial-clinical relations (e.g., team building)
• Supportive organizational culture
• Cooperative inter-org networks
• Key people leading change
1. Individual Interviews & Focus Groups
2. Surveys
a. NWI [60]
b. Goh's Org. Learning Survey [58]
3. Document review
1. Unit leaders
2. Unit staff
3. Hospital leadership
4. Relevant project or committee staff
1. What was the content of the change at the project level, e.g., what in the system was changed to enhance, support and sustain use of an individual, targeted piece of evidence?
2. What was the content of related contextual change for generic, sustained EBP over time, e.g., what key organizational structures, systems, roles, etc. were changed to enhance or support routine use of evidence?
HOW (Process, relative to methods, strategies, or implementation interventions used to try to enable the use of evidence):
How do nursing departments/directorates, and their embedded levels, get EBP implemented ... including on a routine basis?
How and which implementation and other change strategies are used to achieve change at both the individual team and organizational levels relative to successful and sustained implementation of EBP?
• Quality and coherence of policy (e.g., use of evidence)
• Key people leading change (e.g., with appropriate skills)
• Cooperative inter-org networks
• Simplicity and clarity of goals
• Change agenda & its locale
1. Individual Interviews & Focus Groups
2. Document review
3. Targeted group observations
1. Unit leaders
2. Unit staff
3. Hospital leadership
4. Relevant project or committee staff
1. What processes were used to enhance an individual targeted change to EBP, e.g., what implementation interventions were used to encourage adoption of the change?
2. What strategies were used over time to facilitate a change to EBP as the norm? Examples might include nurse manager EBP rounds, targeted leadership retreats, use of an external consultant in EBP, and special communication methods/media focused on EBP and its value.
  1. **Some of the receptive characteristics may be pre-existent when an innovation or vision is proposed, having evolved overtime; or, new conditions may need to be created for innovation to succeed. Thus characteristics may in fact be found under more than one of the major study questions of what, why and how.