Table 2.

Facilitators to ICD-11 implementation and corresponding CFIR 2022 domain and constructs, and ERIC-aligned implementation strategies

CFIR domain	CFIR construct	Facilitator	Implementation strategies
ICD-11	Source	Reputable organizations oversee the implementation	• Identify and prepare champions • Conduct educational meetings
	Evidence-base	Identical to how ICD is crucial for current use cases
	Relative advantage	ICD-11 has extensive content and a terminology service in comparison to ICD-10
	Trialability	Can be piloted to understand user needs and related deficiencies
	Innovation cost	Use of ICD-11 is free of charge.
Outer setting	Partnership and connections	Collaboration with external organizations like universities, the private sector, and WHO	• Involve stakeholders • Obtain and use stakeholders’ feedback
	Policies & Laws	• Directive for ICD-11 implementation from 2024 onwards • Enhancement of current legislation regarding ICD-11 reporting
Inner setting	Relational connections	Centralized and clearly defined roles among all MOH agencies	• Conduct local consensus discussions • Assess for readiness and identify challenges and facilitators
	Communications	• Content that is customized according to professions and roles in the organization • Formal and informal platforms for communication
	Tension for change	• Need to provide answers to specific business and research questions • Consider the complexity and broader range of diseases
	Compatibility	ICD-11 fits with existing systems and workflows
	Access to knowledge & information	• Capacity for self-directed learning • Availability of coding guide
Individuals	Implementation Leads and Team Members	Highly motivated to implement ICD-11	• Conduct ongoing training • Make training dynamic • Provide ongoing consultation
Implement -ation process	Planning	References for steps and milestones related to: • Policies by ICD-11 Implementation or Transition Guide • Systems transition by the Systems’ Development Life Cycle	• Develop a formal implementation blueprint • Develop and implement tools for quality monitoring
	Engaging	Champions involved in nationwide roadshows and attended invitations for talks and training.