Table 2 Description of the context dimensions
Context dimension | Description |
|---|---|
Micro level of health care | |
Patients | Patients’ preferences, expectancies, attitudes, knowledge, needs and resources that can influence implementation |
Meso level of health care | |
Organizational culture and climate | Shared visions, norms, values, assumptions and expectations in an organization that can influence implementation (i.e. organizational culture) and surface perceptions and attitudes concerning the observable, surface-level aspects of culture (i.e. climate). |
Organizational readiness to change | Influences on implementation related to an organization’s tension, commitment or preparation to implement change, the presence of a receptive or absorptive context for change, the organization’s prioritization of implementing change, the organization’s efficacy or ability to implement change, practicality and the organization’s flexibility and innovativeness |
Organizational support | Various forms of support that can influence implementation, including administration, planning and organization of work, availability of staff, staff workload, staff training, material resources, information and decision-support systems, consultant support and structures for learning |
Organizational structures | Influences on implementation related to structural characteristics of the organization in which implementation occurs, including size, complexity, specialization, differentiation and decentralization of the organization |
Macro level of health care | |
Wider environment | Exogeneous influences on implementation in health care organizations, including policies, guidelines, research findings, evidence, regulation, legislation, mandates, directives, recommendations, political stability, public reporting, benchmarking and organizational networks |
Multiple levels of health care | |
Social relations and support | Influences on implementation related to interpersonal processes, including communication, collaboration and learning in groups, teams and networks, visions, conformity, identity and norms in groups, opinion of colleagues, homophily and alienation |
Financial resources | Funding, reimbursement, incentives, rewards, costs and other economic factors that can influence implementation |
Leadership | Influences on implementation related to formal and informal leaders, including managers, key individuals, change agents, opinion leaders, champions, etc. |
Time availability | Time restrictions that can influence implementation |
Feedback | Evaluation, assessment and various forms of mechanisms that can monitor and feed back results concerning the implementation, which can influence implementation |
Physical environment | Features of the physical environment that can influence implementation, e.g. equipment, facilities and supies |