Table 2.
Implementation frameworks used to evaluate implementation outcomes
| Dimensions/Variables Description | Implementation Stage (time period) | |||
|---|---|---|---|---|
| Exploration months 1–10 at all hospitals | Adoption 1 month at each hospital (months 11–12, 17–18, 23–24, 29–30) | Implementation Evaluation/iCT months 13–31 | Sustainment months 17–48 | |
| Reach (RE-AIM Framework) | ||||
| Exclusions: The percentage of eligible ED sites that are excluded pre-randomization. | √ | √ | √ | |
| Participation rate: The number of EDs that participate divided by all EDs that meet the eligibility criteria. | √ | √ | ||
| Characteristics of the participant sites and non- participants sites: Assessment of the following variables: the average number of patients, the average number of staff, staff mix, staff characteristics (age, sex, years of practice) and patient characteristics (age, sex, CTAS score). This will also include assessment of potential moderating factors such as organization readiness for change. | √ | √ | √ | √ |
| Understand barriers and enablers to reach | √ | √ | √ | √ |
| Effectiveness (RE-AIM Framework) | ||||
| Health system level: Length of Stay, Time Until Physician Initial Assessment, Left Without Being Seen | √ | |||
| Patient-reported level: Satisfaction, patient reported experiences of ED service | √ | |||
| Understand barriers and enablers to effectiveness | √ | |||
| Adoption (RE-AIM framework) | ||||
| The proportion of health care providers who engage in SurgeCon activities among those who agreed to participate in the study (acceptability, appropriateness) | √ | √ | √ | |
| Understand barriers and enablers to adoption | √ | √ | √ | |
| Implementation (RE-AIM framework) | ||||
| Fidelity of staff training | √ | |||
| Fidelity of intervention delivery | √ | |||
| Adaptations | √ | |||
| Implementation cost | √ | |||
| Understand barriers and enablers to implementation | √ | |||
| Maintenance (RE-AIM framework) | ||||
| Institutionalization: long-term adoption of SurgeCon | √ | |||
| Cost of maintaining the intervention | √ | |||
| Understand barriers and enablers to maintenance | √ | √ | ||
| Scalability (CFIR framework) | ||||
| Intervention Characteristics: stakeholders’ perception, complexity of intervention | √ | √ | ||
| Outer Setting: health system policy, patients’ needs | √ | √ | √ | √ |
| Inner Setting: resources, leadership | √ | √ | √ | √ |
| Characteristics of Individuals Involved: knowledge, attitude | √ | √ | √ | √ |
| Process of Implementation: planning and training | √ | √ | ||