This question is intended for you to clarify your purpose, aim or goal in your mind and record it before proceeding with the tool. You may also want to consider the type of intended change (e.g., program, practice or policy change).

Some examples of implementation project goals are:

• To develop a plan for implementing and evaluating a patient mobilisation intervention in an acute care hospital
• To evaluate a strategy to implement croup guidelines in emergency for children
• To implement and sustain a public health intervention to optimize influenza vaccine access among older adults living in the community

You may choose to complete the tool more than once for your specific project. For example, if you are looking for a process model AND an evaluation framework, you will need to complete the tool twice, selecting a different option in Q2 each time.

 

a) Describing or guiding my implementation process (i.e., a model)

• Identifying the process or steps for implementing and sustaining my program/intervention
• Implementation models, also called process models, describe the different stages of implementation. They guide the iterative process of translating evidence into practice.¹

 

b) Understanding or explaining implementation outcomes and/or sustainability (i.e., an evaluation framework)

• Evaluation frameworks specify aspects of implementation that could be evaluated to determine implementation success.¹

 

References

1. Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci 2015;10(1):53.

The tool will suggest TMF that cover all selected steps. For more information on the different steps for implementation, please see Health Canada’s Knowledge Translation Planner, published in October 2017, and the Knowledge to Action Cycle.

 

a) Select and/or adapt the evidence

Select the evidence that will inform my program; and adapt the evidence informing my program to the needs of my population.

This step* includes:

Identify, review and select the evidence

• Identify and consult with your stakeholders and target audience(s)
• Define the need and the expected outcomes for your initiative
• Identify the evidence you want to implement

Adapt the evidence to local context

• Identify any adaptations needed to the evidence

 

b) Identify barriers and facilitators and/or select, tailor and implement strategies

Identify the factors that will impact whether my program/intervention will be implemented or sustained; choose appropriate strategies to implement and sustain my program/intervention; and assess the context in which I will apply my chosen strategies, and tailor and implement the strategies.

This step* includes:

Identify the barriers and the facilitators

• Choose the appropriate implementation strategies

Tailor and implement appropriate implementation strategies

• Define the appropriate implementation strategies
• Assess the context for your strategies
• Tailor the strategies
• Prepare to implement the strategies
• Validate your outputs, outcomes and indicators

 

c) Monitor evidence use and/or evaluate outcomes

Monitor the progress and performance of my program/intervention and intervention strategies and identify any needed adjustments; and plan for and carry out an evaluation of my program/intervention and implementation strategies.

This step* includes:

Monitor evidence use

• Plan to monitor evidence use

Evaluate outcomes

• Plan to evaluate outcomes

 

d) Sustain knowledge use

Identify the factors that will affect the sustainability of my program/intervention and create a plan for sustainability.

This step* includes:

Sustain evidence use

• Plan for sustainability

*Source: Health Canada. Knowledge Translation Planner. October 2017.

The tool will suggest TMF that cover, at a minimum, all selected steps.

 

a) Individual-level change

This level deals with the person/individual level and involves “changing behaviour of a single person, or a group of individuals that are bound by common characteristics but do not necessarily work collectively”.

 

b) Organisational-level change

This level deals with the organisation or social institution level and includes the collective behaviour or action of a group of individuals (e.g., a team, an organisation such as a hospital or social institution).

 

c) System- or policy-level change

This level deals with groups larger than an organisation (e.g., multiple hospitals in a network, a community, province or country) and involves systemwide change affecting multiple organisations.

Source: Knowledge Translation Program, St. Michael's Hospital, Unity Health Toronto, Ontario, Canada.