Enhancing organizational readiness for implementation: constructing a typology of readiness-development strategies using a modified Delphi process

Abstract

Background Knowledge about the development of organizational readiness for implementation (ORI) is limited. ORI, referred to as the willingness and capacity of all relevant stakeholders to change practice, is critical for increasing the adoption rate of evidence-based practices and improving implementation outcomes. However, no methodology currently guides ORI’s enhancement or addresses differences in readiness needs across an organization. This study used the transtheoretical model (TTM) as a framework for classifying a well-established compilation of implementation strategies into three readiness stages: pre-contemplation, contemplation, and preparation. Methods A modified Delphi method was used to establish consensus among a panel of purposefully selected research and field implementation experts. The Delphi process involved three rounds of online questionnaires. The third round also included a live video discussion to clarify definitions in an effort to increase consensus among experts. Results Of the 73 strategies reviewed, the experts identified 75% (n = 55) as relevant for pre-implementation and reached a high-level agreement on the assignment of 7% (n = 5) of the strategies to the pre-contemplation stage (ORI-1), 25% (n = 18) to the contemplation stage (ORI-2), and 52% (n = 38) to the preparation stage (ORI-3). Several strategies were identified as relevant to more than one stage. Conclusions Participating experts were able to reach high-level agreement on the relevance of specific sets of implementation strategies to each of the three ORI stages. The lowest number of strategies was assigned to ORI-1 and the highest number to ORI-3. Given the overlap of strategies across ORI stages, there is a need to better understand the specific utilization of such strategies at different stages. Future studies are needed to empirically evaluate the relevance and applicability of this expert-informed typology based on implementers’ experiences in the field.

Examining the complementarity between the ERIC compilation of implementation strategies and the behaviour change technique taxonomy: a qualitative analysis

“…In our analysis, nine ERIC strategies were categorised as having no BCTs indicated in their description or were not targeting behaviour change for the implementation of an innovation. The results align with recent efforts to organise implementation strategies into categories related to their timing [40] and target [49]. In terms of timing, strategies such as assessing readiness and tailoring could be used to prepare for the execution of the innovation or to inform the selection of other strategies.…”

“…With limited information in the strategy description, it was not feasible to code an exhaustive list of all BCTs. A number of studies have highlighted that ERIC strategies vary in their level of specificity [40,41]. It has been suggested that taxonomies such as the ERIC compilation do not possess the granularity and specificity the BCT Taxonomy contains [27].…”

“…In terms of timing, strategies such as assessing readiness and tailoring could be used to prepare for the execution of the innovation or to inform the selection of other strategies. Vax et al assigned these strategies, among others, to readiness stages of pre-contemplation, contemplation, and preparation [40]. In terms of target, we classified four strategies which did not target behaviour change but instead focussed on information gathering or information sharing at an organisational level (work with educational institutions, start a dissemination organisation, develop an implementation glossary, conduct local needs assessment).…”

Tracking, naming, specifying, and comparing implementation strategies for person-centred care in a real-world setting: a case study with seven embedded units

“…Moreover, some of the clusters in ERIC [ 40 ] are clearly directed towards the action target (e.g., Train and educate stakeholders or Support clinicians) , making the coding even more challenging. Our observations are in line with other studies that have highlighted some discrepancies concerning the level of detail across different ERIC strategies [ 7 , 54 , 55 ]. We also acknowledge that other ways of clustering ERIC strategies have been applied in other research initiatives to suit different study objectives [ 2 , 7 , 8 , 10 , 54 ].…”

Co-creating physical activity interventions: Findings from a multiple case study using mixed methods

“…For a more setting-specific application of the organizational readiness concept, the key factors of intervention implementation as identified in our multiple case study might also be useful for a readiness assessment. This readiness judgment should then be followed by a recommendation of strategies to enhance readiness before a co-creation process is conducted, for example, by identifying and preparing a champion [see the typology of readiness development strategies by Vax et al ( 62 )].…”