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Table 6 Definitions of EPIS factors

From: Systematic review of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework

  EPIS constructs Definition Examples
Outer context Service environment/policies* State and federal sociopolitical and economic contexts that influence the process of implementation and delivery/use of the innovation Policies; legislation; monitoring and review; auditing; mandates
Funding/contracting Fiscal support provided by the system in which implementation occurs. Fiscal support can target multiple levels (e.g., staff training, fidelity monitoring, provision of the innovation/EBP) involved in implementation and delivery/use of the innovation Contracting arrangements; grants; fee-for service, addition to formulary; capitation fees, incentives
Leadership Characteristics and behaviors of key decision-makers pertinent at all levels who are necessary but not sufficient to facilitate or promote the implementation process and delivery/use of the innovation Transformational leadership; Implementation leadership
Inter-organizational environment and networks Relationships of professional organizations through which knowledge of the innovation/EBP is shared and/or goals related to the innovation/EBP implementation are developed/established Inter-organizational collaboration, commitment, competition, co-opetition
Patient/client characteristics* Demographics and individual characteristics of the target population/end user Socioeconomic status, health condition, comorbidities, age, gender, motivation
Patient/client advocacy* Support or marketing for system change based on consumer needs, priorities and/or demographics Client advocacy; class-action lawsuits, consumer organizations
Innovation factors* Innovation/EBP developers Characteristics of the individuals or team(s) responsible for the creation of the EBP/innovation that may be the subject of implementation efforts Engagement in implementation, continuous quality improvement, rapid-cycle testing, prototyping
Innovation/EBP Characteristics Features or qualities of innovations to be implemented Complexity, ease of learning, cost, burden, reporting requirements
Innovation/EBP fit* The extent to which the innovation/EBP fits the needs of the population served or context in which it is implemented Innovation/EBP structural and process fit with system, organizations, providers, patients/clients
Bridging factors* Community-academic partnerships* Active partnerships between researchers and key community stakeholders, who can represent multiple levels involved in implementation (e.g., system representatives, organizational leaders, providers, consumers), that can facilitate successful implementation and delivery/use of the innovation Community participation; partnerships; ongoing positive relationships; valuing multiple perspectives
Purveyors/intermediaries Organizations or individuals providing support or consultation for implementation and/or training in the innovation Implementation readiness assessment, strategy development, training support
Inner Context Organizational characteristics Structures or processes that take place and/or exist in organizations that may influence the process of implementation Culture; climate; readiness for change; structure; leadership; receptive context; absorptive capacity; social network support
Leadership Characteristics and behaviors of individuals involved in oversight and/or decision-making related to EBP implementation within an organization Competing priorities; use of climate/culture embedding mechanisms; transformational leadership; implementation leadership
Quality and fidelity monitoring/support* Processes or procedures undertaken to ensure adherence to active delivery of the innovation/EBP and/or an implementation strategy Fidelity support system; quality assurance evaluation; continuous quality improvement
Organizational staffing processes The processes or procedures in place at an organization related to the hiring, review, and retention of staff involved in the active delivery of the innovation/EBP and/or its implementation Professional training and qualification related to EBI delivery; staff turnover
Individual characteristics Shared or unique characteristics of individuals (e.g., provider, supervisor, director) that influence the process of implementation Attitudes towards EBP; demographics and/or background; client characteristics; job demands
  1. *Represents factors that are new or adaptations based on the original EPIS 2011 paper