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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 Visit other sites      
  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