Table I.

“Receptive contexts for change” framework

Factors	Description	Focus of analysis	Empirical focus
Quality and coherence of policy	Evidence-based policy and alignment between goals, feasibility and implementation requirements at both national and local levels	Macro level	The role of policy priorities for improving health care
Environmental pressure	Environmental conditions for transformational change, including political context	Macro level	The role of financial and public concerns to service improvement
Supportive organisational culture	Organisational support and commitment for change	Meso level	The role of shared values, beliefs and patterns of behaviour
Change agenda and its locale	Local political culture and support for organisational changes	Meso level	The role of local pressures to improve health services
Simplicity and clarity of goals and priorities	Identified goals, priorities and a pathway for change that is sustainable over time	Meso level	The role of multiple priorities at both national and local levels
Cooperative inter-organisation network	Joined-up thinking/partnership arrangements across organisational and professional boundaries – formal and informal	Meso level	The role of partnerships, alliances or other collaborations between professionals and organisations working together
Managerial–clinical relations	High-trust managerial–clinical relationships	Micro level	The role of relationship building through multi-disciplinary teams
Key people leading change	Leadership and adoption of a shared vision, values and beliefs	Micro level	The role of credible change agents/champions to lead change/system leadership