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JAMA Article Highlights HSR&D Investigators' Framework for Implementing Innovations

February 3, 2016

Understanding which technological, policy, and organizational changes are most effective for improving healthcare in which contexts is critical if the country is to achieve better, less-expensive care and improved health for everyone. A recent Innovations in Healthcare Viewpoint article in JAMA, "Implementation Science: A Potential Catalyst for Delivery System Reform," describes three ideas that could be helpful, including the application of a well-grounded conceptual framework. They highlight the Consolidated Framework for Implementation Research (CFIR), developed by HSR&D investigators and led by Laura Damschroder, MS, MPH, a member of HSR&D's Center for Clinical Management Research (CCMR) in Ann Arbor, MI. The CFIR is a comprehensive framework designed to promote consistent use of constructs, terminology, and operationalized definitions by consolidating existing models and frameworks from published implementation theories. The article highlights four of the five CIFR domains of variables that interact to influence the adoption and implementation of innovations:

  • External environment (e.g., new payment models),
  • Structure of the organization (e.g., integrated delivery systems),
  • Characteristics of the innovation (e.g., strength of the evidence supporting it), and
  • Processes used (e.g., bottom-up vs top-down decision-making).

The CIFR was originally published in Implementation Science (Damschroder, et al., 2009).