Table 1.
Summary of strategies and clusters, including key characteristics
| Cluster/strategy | Importancea | Feasibilityb | Discipline | Alternate UCD clusterc | |
|---|---|---|---|---|---|
| 1. Access resources | 3.4 | 2.8 | 100% IMP | n/a | |
| 1 | Work with educational institutions | 3.2 | 3.1 | IMP | – |
| 19 | Fund and contract for the clinical innovation | 3.7 | 2.0 | IMP | – |
| 44 | Mandate change | 3.2 | 2.8 | IMP | – |
| 52 | Develop resource sharing agreements | 3.1 | 2.9 | IMP | – |
| 60 | Access new funding | 3.8 | 2.2 | IMP | – |
| 62 | Use train-the-trainer strategies | 3.4 | 3.5 | IMP | – |
| 2. Promote leadership and collaboration | 3.9 | 3.4 |
80% IMP 20% UCD |
n/a | |
| 4 | Identify and prepare champions | 4.2 | 4.0 | IMP | – |
| 5 | Recruit, design, and train for leadership | 4.1 | 3.7 | IMP | – |
| 13 | Build a coalition | 4.1 | 3.7 | IMP | – |
| 22 | Obtain formal commitments | 3.2 | 3.5 | IMP | – |
| 9 | Build a user-centered organizational culture | 3.7 | 2.3 | UCD | – |
| 3. Incentivize the innovation | 2.9 | 1.8 | 100% IMP | n/a | |
| 2 | Place innovation on fee for service lists/formularies | 3.5 | 2.2 | IMP | – |
| 23 | Increase demand | 2.8 | 1.9 | IMP | – |
| 33 | Change accreditation or membership requirements | 2.4 | 1.6 | IMP | – |
| 35 | Alter patient/consumer fees | 2.9 | 1.7 | IMP | – |
| 37 | Alter incentive/allowance structures | 3.5 | 2.2 | IMP | – |
| 50 | Create or change credentialing and/or licensure standards | 2.6 | 1.5 | IMP | – |
| 4. Monitor change | 3.7 | 3.2 | 100% IMP | n/a | |
| 8 | Change record systems | 3.4 | 2.5 | IMP | – |
| 12 | Purposefully reexamine the implementation | 4.1 | 4.0 | IMP | – |
| 20 | Develop and implement tools for quality monitoring | 3.8 | 3.1 | IMP | – |
| 45 | Audit and provide feedback | 3.9 | 3.6 | IMP | – |
| 48 | Use data experts | 3.0 | 3.3 | IMP | – |
| 55 | Facilitate relay of clinical data to providers | 3.8 | 2.9 | IMP | – |
| 65 | Develop and organize quality monitoring systems | 3.6 | 3.2 | IMP | – |
| 5. Support providers | 3.4 | 3.4 | 100% IMP | n/a | |
| 16 | Remind clinicians | 2.8 | 3.6 | IMP | – |
| 21 | Conduct ongoing training | 3.7 | 3.6 | IMP | – |
| 39 | Centralize technical assistance | 3.1 | 3.0 | IMP | – |
| 40 | Provide ongoing consultation | 3.7 | 3.7 | IMP | – |
| 47 | Provide local technical assistance | 3.6 | 3.3 | IMP | – |
| 6. Facilitate change | 4.0 | 3.8 | 100% IMP | n/a | |
| 28 | Tailor strategies | 4.3 | 3.9 | IMP | – |
| 36 | Facilitation | 3.7 | 3.7 | IMP | 7 |
| 42 | Organize clinician implementation team meetings | 3.7 | 3.6 | IMP | – |
| 53 | Develop educational materials | 3.6 | 4.4 | IMP | – |
| 63 | Promote adaptability | 4.4 | 3.7 | IMP | – |
| 7. Develop and test solutions rapidly | 3.3 | 4.0 | 100% UCD | ||
| 3 | Use generative object-based techniques | 3.0 | 3.9 | UCD | 6 |
| 27 | Engage in cycles of rapid prototyping | 3.9 | 3.9 | UCD | 6 |
| 30 | Conduct focus groups about user perspectives | 3.4 | 4.5 | UCD | 9 |
| 31 | Use associative object-based techniques | 2.4 | 3.8 | UCD | 9 |
| 34 | Engage in live prototyping | 3.7 | 3.6 | UCD | 6 |
| 49 | Conduct interviews about user perspectives | 3.7 | 4.5 | UCD | 9 |
| 58 | Develop personas and schemas | 2.9 | 3.9 | UCD | 9 |
| 8. Understand systems and context | 3.8 | 4.0 |
83% UCD 17% IMP |
||
| 7 | Define work flows | 3.8 | 4.2 | UCD | 8 |
| 11 | Engage in iterative development | 4.5 | 3.9 | UCD | 7 |
| 18 | Apply process maps to systems-level behavior | 3.1 | 3.5 | UCD | 8 |
| 38 | Conduct observational field visits | 4.3 | 4.1 | UCD | 9 |
| 43 | Prepare and present user research reports | 3.3 | 4.3 | UCD | 8 |
| 56 | Assess for readiness and identify barriers and facilitators | 3.9 | 4.1 | IMP | 8 |
| 9. Consider user needs and experiences | 3.1 | 3.8 | 100% UCD | ||
| 17 | Conduct experience sampling | 2.7 | 3.3 | UCD | 9 |
| 24 | Conduct usability tests | 4.0 | 4.2 | UCD | 6 |
| 25 | Apply task analysis to user behavior | 3.3 | 3.9 | UCD | 9 |
| 29 | Develop a user research plan | 3.7 | 4.1 | UCD | 6 |
| 32 | Conduct heuristic evaluation | 2.4 | 3.7 | UCD | 6 |
| 46 | Examine automatically generated data | 3.4 | 3.8 | UCD | 7 |
| 51 | Conduct artifact analysis | 2.8 | 3.6 | UCD | 9 |
| 54 | Conduct competitive user experience research | 3.0 | 3.6 | UCD | 9 |
| 57 | Develop experience models | 3.1 | 3.7 | UCD | 9 |
| 64 | Collect quantitative survey data on potential users | 3.1 | 4.1 | UCD | 9 |
| 66 | Use dialogic object-based techniques | 2.8 | 3.7 | UCD | 9 |
| 10. Co-design solutions | 4.0 | 4.0 |
75% UCD 25% IMP |
||
| 6 | Conduct co-creation sessions | 4.1 | 3.9 | UCD | 6 |
| 14 | Recruit potential users | 4.1 | 4.1 | UCD | 9 |
| 15 | Conduct design charrette sessions with stakeholders | 3.1 | 3.6 | UCD | 6 |
| 26 | Conduct interpretation sessions with stakeholders | 3.7 | 4.0 | UCD | 8 |
| 59 | Design in teams | 3.9 | 4.1 | UCD | 7 |
| 61 | Define target users and their needs | 4.5 | 4.4 | UCD | 6 |
| 10 | Conduct local consensus discussions | 4.2 | 3.8 | IMP | 8 |
| 41 | Involve patients/consumers and family members | 4.2 | 4.0 | IMP | 8 |
Strategies are organized by discipline (IMP implementation, UCD user-centered design) within each cluster
aRating scale ranged from 1 (relatively unimportant) to 5 (extremely important)
bRating scale ranged from 1 (not at all feasible) to 5 (extremely feasible)
cFor clusters dominated by UCD strategies, indicates the alternate cluster in which a given strategy was located based on a nine-cluster solution from sorting responses of UCD expert participants (valid response n = 21); those clusters (detailed in Additional file 2) are as follows: 6. Develop and test solutions rapidly; 7. Unnamed new cluster; 8. Understand systems and context; and 9. Consider user needs and experiences