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Table 1 Elements of Promoting Action on Research Implementation in Health Systems (PARIHS) framework

From: Knowledge implementation in health care management: a qualitative study

Elementssub elements
LowHigh
EvidenceResearch• Poorly conceived, designed, and/or executed research
• Seen as only type of evidence
• Not valued as evidence
• Seen as certain
• Well-conceived, deigned, and executed research, appropriate to the research question
• Seen as one part of a decision
• Valued as evidence
• Lack of certain acknowledged
• Judged as relevant
• Importance weighted
• Conclusion drown
Clinical experience• Anecdotal, with critical reflection and judgment
• Lack of consensus within similar groups
• Not valued as evidence
• Seen as only type of evidence
• Clinical experience and expertise reflected upon, tested by individuals and groups
• Consensus within similar groups
• Valued as evidence
• Seen as only type of evidence
• Judged as relevant
• Importance weighted
• Conclusion drown
Patient experience• Not valued as evidence
• Seen as only type of evidence
• Patient not involved
• Valued as evidence
• Multiple biographic used
• Partnership with healthcare professionals
• Seen as only type of evidence
• Judged as relevant
• Importance weighted
• Conclusion drown
Local data/ information• Not valued as evidence
• Lack of systematic methods for collection and analysis
• Not reflected upon
• Not Conclusion drown
• Valued as evidence
• Collected and analysis systematically rigorously
• Evaluated and reflected upon
• Conclusion drown
ContextCulture• Unclear valued and beliefs
• Low regard for individuals
• Task driven organization
• Lake of consistency
• Resources not allocated
• Well integrated with strategic goals
• Abel to define cultures in terms of prevailing values / beliefs
• Values individual staff and clients
• Promotes learning organization
• Consistency of individuals role/experience to value relationship with others teamwork
• Power and authority
• Rewards /recognition
• Resources-human, financial, equipment, allocated
• Initiative fits with strategic goals and is a key practice/patient issue
Leadership• Traditional, command, and control leadership
• Lack of role clarity
• Lack of teamwork
• Poor organizational structures
• Autocratic decision-making processes
• Didactic approaches to learning/teaching/managing
• Transformational leadership
 • Role clarity
• Effective teamwork
• Effective organizational structures
• Democratic-inclusive decision-making processes
• Enabling/empowering approach to teaching/learning/managing
Evaluation• Absence of any form of feedback
• Narrow use of performance information sources
• Evaluations rely on single rather than multiple methods
• Feedback on Individual Team System performance
• Use of multiple sources of
information on performance
• Use of multiple methods Clinical Performance Economic Experience evaluations
FacilitationPurposeTask
Doing for others
 • Episodic contact
 • Practical/technical help
 • Didactic, traditional approach to teaching
 • External agents
 • Low intensity—extensive coverage
Holistic Role
Enabling others
• Sustained partnership
• Developmental
• Adult learning approach to teaching
• Internal/external agents
• High intensity—limited coverage
Skills and attributesTask/doing for others
 • Project management skills
 • Technical skills
 • Marketing skills
 • Subject/technical/clinical credibility
Holistic/enabling others
 • Cocounseling
 • Critical reflection
 • Giving meaning
 • Flexibility of role
 • Realness/authenticity