Table 1.

Inspired by practical tools, such as the Business Canvas and Lean Canvas, we provide examples of generic questions or areas of enquiry that may help begin to uncover the status of the three core resources and five motive forces in facilities forming the context of a proposed intervention⁶⁰

Physical and material resources Is the basic infrastructure sufficient to support the intervention/change? If not are any changes needed to physical layouts? If so who might these affect? Are all the basic tools and materials consistently) available to offer care as a platform for any intervention/change? If there are infrastructure, layout or material deficiencies what needs to be done/added and who will do this, how and who will bear the cost? Will the intervention/change require new resources? How will these be provided? Will these incur additional costs? How will they be sustained beyond any project? For technologies how will these be maintained or disposed of?		Workforce capacity and capability Are there sufficient staff to provide expected forms of routine care now? if not then which personnel/skills are inadequate? How will an intervention/change be impacted by any existing personnel shortages and can these shortages be addressed? Does the intervention/change comprise ‘new work’? who will do this work? What other forms of work might not be done if new work is prioritised? Does it require new skills? Who needs to have these skills and how will they be provided? How will new skills be retained or spread during and after any project? How will desired skills in practice be monitored? What ‘shortcuts’ or ‘workarounds’ can be anticipated as workers assimilate the intervention/change?	Relationships Who is involved in delivering the intervention/change and which positions/people would have any supervisory or management responsibility? How are these people in the facility organised in formal roles/teams? Are there important informal groupings? How well in general do these people/groups work together currently? Are there specific professional groups or parts of the facility that may need to collaborate to deliver the intervention/change, what are relationships like between these different parties? How might the intervention/change affect existing formal and informal organisational structures, routines or roles? How might this be perceived by different groups? Have there been previous intervention/change initiatives? What affected their success?
Goals Are the specific intervention/change goals clear and important to people from top to bottom of the system? Are there clear, possibly more important competing priorities? What work needs to be done to gain agreement on goals?	Action team Who in formal or informal leadership positions will need to drive the intervention/change? How might they be supported to navigate existing hierarchies? Why might joining this leadership team be attractive? How will the interpersonal and professional skills of this team be developed?	Organisational support What processes might be used to engage senior and mid-level managers to plan for the intervention change? What room do they have to adapt a standard plan? How, will authority be delegated and support given in practice to front-line teams? Is support of other influential stakeholders such as professional regulators needed? How will success be recognised or other incentives used?	Responsiveness How will senior managers be kept informed of intervention/change success and impacts? Do senior managers have the capacity to mobilise and deploy modest resources to address local resource or personnel needs as they arise? Are there longer term needs for procurement and planning? What advice and support may be needed to support this? How will success be recognised or other incentives used?	Learning What monitoring and evaluation is proposed, is it feasible in the long term, and how does it engage and inform decision-making? How might information be shared across settings to help national managers identify challenges, make and test course corrections? Who is taking on the work of such learning, do they have the time and the skills to do this and who is responsible for the process?

A large, blank print version of this type of representation might be used to generate ideas in a workshop, or thematic areas might be tackled as individual topics. Aggregating key findings in such a matrix may help identify cross-linkages or dependencies that inform intervention thinking.