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Table 5 Simpson Transfer Model stages and corresponding activities

From: EQUIP: Implementing chronic care principles and applying formative evaluation methods to improve care for schizophrenia: QUERI Series

STM stages Intervention components and tools Formative evaluation
Exposure • Secure commitment Developmental evaluation
  • Training and observation of care model by site PIs and regional project managers • Organizational Readiness for Change (ORC: prior to implementation)
  • Review evidence • Key informant interviews
  • Address values  
  • Identify and prioritize needs and treatment targets  
  • Begin tailoring care practice protocols  
  • Kick-off meeting and video conferences on treatments to be implemented  
Adoption Predisposing activities: Developmental evaluation
  • VISN Implementation Teams Rogers' adoption questions:
  • Product champions • Complexity
  • Continue tailoring care practice protocols • Relative advantage
  • Continue to secure commitment, address values • Observability
Implementation Enabling activities: Progress-focused evaluation
  • Patient self- assessment informatics (PAS) with provision of data to clinicians. • PAS tracking (ongoing)
  • Treatment-specific implementation activities, such as help with wellness groups and liaison with supported employment. Implementation-focused evaluation
  • Discuss and start using provider supports and incentives. • Project documents (minutes from Implementation Team meetings, project managers' field notes, quality coordinators' logs: all ongoing).
   • Provider and clinic manager interviews (mid-implementation)
Practice Reinforcing activities (performance monitoring & feedback): Interpretive evaluation
  • Monthly quality meeting and Quality Reports • Provider & clinic manager interviews (post-implementation)
  • Quarterly conference calls re: treatment target implementation and use • Computer system usability questionnaire
  • Implementation team meetings  
  • Continue tailoring with provider input  
  • Finalize provider supports and incentives  
  • Continue tailoring with leader input  
Sustainability • Stakeholder feedback discussions Interpretive evaluation
   • Level of Institutionalization
   • ORC