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Table 2 Description of the CFIR domains and the operationalization of the constructs used in the study

From: Implementation of a national policy for improving health and social care: a comparative case study using the Consolidated Framework for Implementation Research

Domains Operationalization of the constructs and sub-constructs
Intervention characteristics Innovation Source: Perception of key stakeholders about whether the innovation is externally or internally developed.
Evidence Strength and Quality: Perceptions of the quality and validity of evidence supporting the belief that the innovation will have the desired outcomes.
Relative Advantage: Perception of the advantages of implementing the policy versus alternative solutions, as well as advantages (or disadvantages) of the separate components.
Adaptability: Perceived possibilities to adapt, tailor, refine or reinvent the policy to meet local needs.
Trialability: The ability to test the policy content on a small scale in the organizations and to be able to “undo” implementation if warranted.
Complexity: Perceived difficulty of the policy, reflected by duration, scope, radicalness and disruptiveness.
Design Quality and Packaging: Perceived excellence in how the policy is bundled and presented; e.g., supporting materials and the overall composition of the policy.
Outer setting Needs and Resources of Those Served by the Organization: The extent to which the needs of elderly with complex health needs are acknowledged by the organization.
Cosmopolitanism: Communications and networks with actors and organizations external to the county and its health and social care organizations.
Peer Pressure: Mimetic or competitive pressure to implement the policy in relation to county councils and municipalities in other counties.
External Policy and Incentives: Perception of the policy as an external initiative and the performance bonuses as a policy instrument.
Inner setting Structural Characteristics: The organizational structures for collaboration between actors in health and social care for elderly with complex health needs.
Networks and Communications: The presence and quality of formal and informal communication and networks between health and social care for elderly with complex health needs.
Implementation Climate
Tension for Change: Perceived need for change regarding the policy goals.
Compatibility: The fit between the policy and the current structures and workflows and the organization’s needs and values.
Relative Priority: Shared perception of the importance of implementing the policy.
Organizational Incentives and Rewards: Incentives tied to indicators within the policy improvement areas.
Goals and Feedback: Monitoring policy goals and offering feedback to staff and managers.
Readiness for Implementation
Leadership Engagement: Commitment and involvement of leaders regarding the implementation of the policy.
Available Resources: Resources available for local implementation.
Access to Knowledge and Information: Ease of access to information, knowledge and support about how to implement the policy.
Process Planning: The degree to which the policy goals are broken down and implementation activities are specified on local level.
Engaging
Formally Appointed Internal Implementation Leaders: Attracting and involving improvement coaches and members of senior management teams and their roles in the implementation.