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Table 4 Core operational research question and sample related sub-questions: Implementation interventions and strategic processes

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

What strategic approaches or implementation interventions are used to a) facilitate implementation at the project level and b) create normalization of EBP within a health care system at multiple institutional levels?
1. WHY: What was/were the specific motivation/s for change/s, i.e., why did targeted departments/services and their embedded levels wish to/implement EBP?
   i. In terms of specific projects.
   ii. In general, within the department/service and other embedded levels.
2. HOW: What was the process used to create an individual change to EBP, i.e., what was the method used to try to get EBP implemented?
   i. Which, if any, specific implementation interventions/strategies were used to try to enable the use of an individual, targeted piece or program of evidence?
E.g., use of a dedicated project lead? Use of a standard organizational approach to change project? Use of a facilitator/champion? Use of E-B change strategies, e.g., audit/feedback, opinion leadership, QI team, clinical reminder, etc.?
3. WHAT: What was the content of related contextual change for generic, sustained EBP over time?
   i. What key contextual elements or other entities in the system were changed to enhance or support the routine use of evidence?
▪ E.g., alignment of infrastructure with the new purpose, values, vision, strategy, priorities ...i.e., change in various operational structures, systems, roles, job descriptions, processes, and relations; budgeting; etc.