Table 5.

Theory areas associated with implementation strategies

ERIC strategy	Domain	Associated concepts (bold) and intended outcomes	Associated initial programme theories
Develop a formal implementation blueprint	Baseline assessment and planning	Clear implementation plan or blueprint for change Clear aim of improving patient outcomes: Clear communication of expectations across sites; tool for planning changes. Provide support for comparison across sites implementing the intervention	Social Cognitive Theory
Conduct cyclical small tests of change	Ongoing assessment	Designed with adaptation to local settings in mind: Incremental changes easier than multifaceted ones.	Social Cognitive Theory
Promote adaptability; purposely re-examine the implementation	Ongoing assessment	Designed with adaptation to local settings in mind: Negotiation, needs assessment, ownership of change.	Social Cognitive Theory
Build a coalition; create new clinical teams	Partnering	Facilitate access to reputable advice and problem-solving assistance: Inclusion, trust, common goal, breadth of expertise.	Partnership Synergy Theory
Develop academic partnerships; use an implementation advisor; use advisory boards and workgroups	Partnering	Facilitate access to reputable advice and problem-solving assistance: Breadth of expertise, social support.	Partnership Synergy Theory
Align with other priorities	Social processes	Formal period of planning and needs assessment: Assess the fit with current workflow, personal and organisational goals aligned.	Organisational Readiness Theory Social Cognitive Theory
Conduct local needs assessment	Baseline assessment and planning	Formal period of planning and needs assessment: Assessing readiness; understanding implications of change on workflow and practice. Designed with adaptation to local settings in mind	Organisational Readiness Theory
Assess for readiness and identify barriers and facilitators	Baseline assessment and planning	Formal period of planning and needs assessment: Setting up conditions that support change.	Organisational Readiness Theory
Change physical structure and equipment	Accessing resources	Provide or facilitate practical support in the form of resources and equipment: Aligning structure with process.	Partnership Synergy Theory
Use data experts	Partnering	Provide data support for new or changed IT systems, baseline audits and ongoing monitoring: Partnership with experts to support change.	Partnership Synergy Theory
Develop resource sharing agreements	Partnering	Provide or facilitate practical support in the form of resources and equipment: Working with others to effect change.	Partnership Synergy Theory
Develop educational materials	Baseline assessment and planning	Formal period of planning and needs assessment: Setting up educational support/conditions that support change.	Organisational Readiness Theory
Distribute educational materials	Accessing resources	Provide practical support in the form of education and skill acquisition: Knowledge and skill acquisition, increase in personal and collective competence and confidence.	Social Cognitive Theory
Provide clinical supervision	Social processes and influences	Provide practical support in the form of education and skill acquisition: Social support, role modelling, and practice of new behaviours. Provide social support from executive sponsorship, supervised practice, project officers, opinion leaders or champions	Social Cognitive Theory
Access new funding	Accessing resources	Provide practical support in the form of resources and equipment: Setting up conditions that support change.	Partnership Synergy Theory
Create a learning collaborative	Social processes	Provide social support from executive sponsorship, supervised practice, project officers, opinion leaders or champions: Social influences supporting change and learning.	Diffusion of innovation Organisational Readiness Theory
Facilitation	Social processes	Provide social support from executive sponsorship, supervised practice, project officers, opinion leaders or champions: Breadth of expertise, social support.	Diffusion of innovation
Identify and prepare champions; inform local opinion leaders	Social processes	Provide social support from executive sponsorship, supervised practice, project officers, opinion leaders or champions: Social influence supporting change.	Diffusion of innovation Organisational Readiness Theory
Involve executive boards; obtain formal commitments	Social processes	Provide social support from executive sponsorship, supervised practice, project officers, opinion leaders or champions: Trust, social support, legitimacy, accountability.	Social Cognitive Theory Diffusion of Innovation Organisational Readiness Theory
Recruit, designate, and train for leadership	Social processes	Provide social support from executive sponsorship, supervised practice, project officers, opinion leaders or champions: Social influence supporting change. Provide or facilitate practical support in the form of education and skill acquisition:	Social Cognitive Theory Diffusion of innovation
Organise clinician implementation team meetings	Social processes	Provide social support from executive sponsorship, supervised practice, project officers, opinion leaders or champions: Social influence supporting change, setting common goals and expectations.	Organisational Readiness Theory Theory of Planned Behaviour
Conduct local consensus discussions	Social processes	Provide social support from executive sponsorship, supervised practice, project officers, opinion leaders or champions: Social influence supporting the setting of clear objectives, building local trust, planning. Designed with adaptation to local settings in mind	Organisational Readiness Theory Partnership Synergy Theory Theory of Planned Behaviour
Audit and provide feedback	Baseline assessment and planning Ongoing assessment	Formal period of planning and needs assessment: Setting up tension for change. Provide support for comparison across sites implementing the intervention: Standardised collection of data sets up a tension for change, diagnoses areas for individual sites to work on, and tracks progress locally and across sites.	Organisational Readiness Theory
Capture and share local knowledge	Social processes	Support for comparison across sites implementing the intervention: Increase the breadth of expertise, social support.	Social Cognitive Theory
Develop and implement tools for quality monitoring	Baseline assessment and planning Ongoing assessment	Support for implementation built into intervention: Setting up conditions that foster change and decrease participant effort. Provide support for comparison across sites implementing the intervention	Organisational Readiness Theory

ERIC, Expert Recommendations for Implementing Change; IT, information technology.