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Table 2 Respondents’ selections for which strategies belonged to a phase (n = 51), n (%)

From: Iowa Implementation for Sustainability Framework

Strategy number/name

Creating awareness and interest

Building knowledge and commitment

Promoting action and adoption

Pursuing integration and sustainability

p-value

01

Action plan

32 (62.8)

34 (66.7) §

42 (82.4) §

32 (62.8)

0.034

02

Actionable and timely data feedback

19 (37.3)

26 (51.0)

34 (66.7) §

32 (62.8)

0.003

03

Advisory boards

04

Announcements and broadcasts

42 (82.4) §

25 (49.0)

25 (49.0)

22 (43.1)

< 0.0001

--

Annual report

23 (45.1)

16 (31.4)

16 (31.4)

3 (64.7) §

0.0008

05

Audit and feedback

21 (41.2)

21 (41.2)

31 (60.8)

35 (68.6) §

0.003

06

Audit key indicators

21 (41.2)

22 (43.1)

30 (58.8) §

33 (64.7)

0.015

07

Benchmark data

27 (52.9)

24 (47.1) §

30 (58.8)

36 (70.6)

0.034

08

Case studies

29 (56.9)

31(60.8) §

31 (60.8)

21 (41.2)

0.056

09

Celebrate local unit progress

23 (45.1)

25 (49.0)

30 (58.8)

37 (72.6) §

0.004

10

Change agents (e.g., change champion, core group, opinion leader, thought leader, etc.)

32 (62.8)

35 (68.6) §

34 (66.7) §

28 (54.9)

0.241

11

Checklist

19 (37.3)

22 (43.1)

37 (72.6) §

25 (49.0)

0.0002

12

Clinician input

27 (52.9)

35 (68.6) §

32 (62.8)

29 (56.9)

0.102

13

Cultural broker

--

Competency metric for discontinuing training

16 (31.4)

20 (39.2)

18 (35.3)

24 (47.1) §

0.313

--

Continuing education programs

20 (39.2) §

36 (70.6)

26 (51.0)

28 (54.9)

0.002

14

Data collection by clinicians

19 (37.3)

24 (47.1)

31 (60.8) §

28 (54.9)

0.032

15

Decision algorithm

     

16

Demonstrate workflow or decision algorithm

18 (35.3)

29 (56.9)

34 (66.7) §

30 (58.8)

0.002

17

Disincentives

18

Disseminate credible evidence with clear implications for practice

25 (49.0)

22 (43.1) §

28 (54.9)

32 (62.8)

0.10

19

Distribute key evidence

22 (43.1) §

26 (51.0)

25 (49.0)

29 (56.9)

0.419

20

Documentation

15 (29.4)

17 (33.3)

25 (49.0) §

26 (51.0)

0.014

21

Education (e.g., live, virtual, or computer-based)

27 (52.9)

35 (68.6) §

28 (54.9)

22 (43.1)

0.004

22

Educational outreach or academic detailing

23 (45.1)

31 (60.8) §

25 (49.0) §

22 (43.1)

0.116

23

“Elevator speech”

29 (56.9)

26 (51.0)

20 (39.2) §

15 (29.4)

0.001

--

Financial incentives

16 (31.4)

13 (25.5)

22 (43.1)

25 (49.0) §

0.017

24

Focus groups for planning change

23 (45.1)

23 (45.1) §

28 (54.9)

22 (43.1)

0.477

25

Gaming

26

Gap assessment/gap analysis

27 (52.9)

26 (51.0) §

25 (49.0)

18 (35.3)

0.135

27

Give evaluation results to colleagues

18 (35.3)

19 (37.3)

28 (54.9) §

31 (60.8)

0.002

28

Highlight advantages or anticipated impact

27 (52.9) §

27 (52.9)

26 (51.0)

25 (49.0)

0.939

29

Highlight compatibility

16 (31.4) §

21 (41.2)

23 (45.1)

18 (35.3)

0.332

30

Incentives

21 (41.2)

20 (39.2)

28 (54.9) §

25 (49.0)

0.215

31

Individual performance evaluation

15 (29.4)

17 (33.3)

31 (60.8) §

25 (49.0)

0.0006

32

Individualize data feedback

15 (29.4)

16 (31.4)

29 (56.9)

25 (49.0) §

0.0016

33

Inform organizational leaders

21 (41.2)

21 (41.2) §

25 (49.0)

24 (47.1)

0.692

34

Integrate practice change with other EBP protocols

13 (25.5)

20 (39.2) §

29 (56.9)

30 (58.8)

0.0003

35

Interprofessional discussion and troubleshooting

36

Journal club

27 (52.9) §

32 (62.8)

21 (41.2)

12 (23.5)

< .0001

37

Knowledge broker(s)

26 (51.0) §

30 (58.8)

22 (43.1)

14 (27.5)

0.001

38

Learning collaborative

39

Link practice change and power holder/stakeholder priorities

22 (43.1)

28 (54.9) §

28 (54.9)

25 (49.0)

0.373

40

Link to patient/family needs and organizational priorities

23 (45.1)

23 (45.1)

28 (54.9) §

25 (49.0)

0.521

41

Local adaptation and simplify

14 (27.5)

16 (31.4) §

28 (54.9)

25 (49.0)

0.0006

42

Make impact observable

19 (37.3)

21 (41.2) §

26 (51.0)

29 (56.9)

0.044

43

Match practice change with resources and equipment

12 (23.5)

16 (31.4) §

27 (52.9)

27 (52.9)

0.0001

44

Mobile “show on the road”

23 (45.1) §

20 (39.2)

21 (41.2)

22 (43.1)

0.861

--

Multidisciplinary discussion and troubleshooting

16 (31.4)

25 (49.0)

30 (58.8) §

27 (52.9)

0.001

45

Non-punitive discussion of results

13 (25.5)

15 (29.4)

25 (49.0) §

26 (51.0)

0.001

46

Patient decision aids

16 (31.4)

23 (45.1)

28 (54.9) §

22 (43.1)

0.032

47

Patient reminders

13 (25.5)

16 (31.4)

26 (51.0) §

21 (41.2)

0.005

--

Peer influence

24 (47.1)

24 (47.1)

26 (51.0)

22 (43.1) §

0.738

48

Personalize the messages to staff (e.g., reduces work, reduces infection exposure, etc.) based on actual improvement data

27 (52.9)

27 (52.9)

23 (45.1)

20 (39.2) §

0.322

49

Pocket guides

19 (37.3)

22 (43.1) §

29 (56.9)

24 (47.1)

0.047

50

Positive deviance

     

51

Posters and postings/fliers

23 (45.1) §

25 (49.0)

24 (47.1)

23 (45.1)

0.943

--

Present in educational programs

25 (49.0)

30 (58.8)

28 (54.9)

18 (35.3) §

0.008

52

Project responsibility in unit or organizational committee

14 (27.5)

23 (45.1)

27 (52.9)

26 (51.0) §

0.004

53

Provide recognition at the point of care

15 (29.4)

20 (39.2)

25 (49.0) §

26 (51.0)

0.016

54

Public recognition

18 (35.3)

16 (31.4)

22 (43.1)

27 (52.9) §

0.013

55

Publicize new equipment

18 (35.3) §

16 (31.4)

27 (52.9)

24 (47.1)

0.010

56

Reminders or practice prompts

16 (31.4)

20 (39.2)

29 (56.9) §

26 (51.0)

0.004

57

Report into quality improvement program

11 (21.6)

15 (29.4)

24 (47.1) §

25 (49.0) §

0.0007

58

Report progress and updates

12 (23.5)

14 (27.5)

25 (49.0) §

28 (54.9)

< .0001

59

Report to senior leaders

11 (21.6)

12 (23.5) §

22 (43.1) §

27 (52.9) §

0.0002

60

Report within organizational infrastructure

14 (27.5)

18 (35.3) §

23 (45.1)

28 (54.9)

0.005

60

Resource manual or materials (i.e., electronic or hard copy)

15 (29.4)

24 (47.1) §

28 (54.9)

24 (47.1)

0.011

61

Resource materials and quick reference guides

17 (33.3)

25 (49.0)

30 (58.8) §

25 (49.0)

0.010

62

Quick reference guide

63

Revise policy, procedure, or protocol

11 (21.6)

15 (29.4)

24 (47.1)

28 (54.9) §

< .0001

64

Revise professional roles

65

Role model

18 (35.3)

23 (45.1)

29 (56.9) §

27 (52.9)

0.008

66

Rounding by unit and organizational leadership

23 (45.1)

21 (41.2)

29 (56.9) §

25 (49.0)

0.154

67

Self-learning

68

Senior executives’ announcements

19 (37.3) §

14 (27.5)

21 (41.2)

22 (43.1)

0.207

69

Share protocol revisions with clinician that are based on feedback from clinicians, patient, or family

13 (25.5)

19 (37.3)

27 (52.9)

22 (43.1) §

0.009

70

Simplify

71

Skill competence

11 (21.6)

23 (45.1)

30 (58.8) §

20 (39.2)

< .0001

72

Slogans and logos

25 (49.0) §

19 (37.3)

21 (41.2)

16 (31.4)

0.138

73

Social media influencer

     

74

Sound bites

26 (51.0) §

16 (31.4)

20 (39.2)

16 (31.4)

0.036

75

Staff meetings

25 (49.0) §

24 (47.1)

26 (51.0)

23 (45.1)

0.842

76

Standing orders

9 (17.7)

13 (25.5)

27 (52.9) §

26 (51.0)

< .0001

--

Strategic plan

14 (27.5)

15 (29.4)

24 (47.1)

26 (51.0) §

0.004

77

Teamwork

26 (51.0)

29 (56.9) §

31 (60.8)

29 (56.9)

0.459

78

Trend results

16 (31.4)

18 (35.3)

27 (52.9)

24 (47.1) §

0.025

79

Troubleshoot use/application

9 (17.7)

21 (41.2) §

28 (54.9)

24 (47.1)

< .0001

80

Troubleshooting at the point of care/bedside

8 (15.7)

17 (33.3)

27 (52.9) §

26 (51.0)

< .0001

81

Try the practice change

11 (21.6)

17 (33.3)

31 (60.8) §

21 (41.2)

< .0001

82

Unit inservices

22 (43.1) §

27 (52.9)

29 (56.9)

23 (45.1)

0.174

83

Unit newsletter

25 (49.0) §

27 (52.9)

25 (49.0)

26 (51.0)

0.932

84

Unit orientation

22 (43.1)

24 (47.1)

24 (47.1) §

20 (39.2)

0.619

--

Update practice reminders

18 (35.3)

21 (41.2)

24 (47.1)

28 (54.9) §

0.033

85

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  1. Bold represents the most frequently selected phase and statistical significance at p < 0.05 using Cochran’s Q test
  2. §Indicates which phase the strategy was listed in the original framework
  3. The p-value examines whether there was a significant difference in responses between the phases. If the strategy does not have a strategy #, that strategy was not used for the card pile sort
  4. Italicized strategies indicate the strategy was not used in the survey