From: Systematic review of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework
 | EPIS constructs | Definition | Examples |
---|---|---|---|
Outer context | Service environment/policies* | State and federal sociopolitical and economic contexts that influence the process of implementation and delivery/use of the innovation | Policies; legislation; monitoring and review; auditing; mandates |
Funding/contracting | Fiscal support provided by the system in which implementation occurs. Fiscal support can target multiple levels (e.g., staff training, fidelity monitoring, provision of the innovation/EBP) involved in implementation and delivery/use of the innovation | Contracting arrangements; grants; fee-for service, addition to formulary; capitation fees, incentives | |
Leadership | Characteristics and behaviors of key decision-makers pertinent at all levels who are necessary but not sufficient to facilitate or promote the implementation process and delivery/use of the innovation | Transformational leadership; Implementation leadership | |
Inter-organizational environment and networks | Relationships of professional organizations through which knowledge of the innovation/EBP is shared and/or goals related to the innovation/EBP implementation are developed/established | Inter-organizational collaboration, commitment, competition, co-opetition | |
Patient/client characteristics* | Demographics and individual characteristics of the target population/end user | Socioeconomic status, health condition, comorbidities, age, gender, motivation | |
Patient/client advocacy* | Support or marketing for system change based on consumer needs, priorities and/or demographics | Client advocacy; class-action lawsuits, consumer organizations | |
Innovation factors* | Innovation/EBP developers | Characteristics of the individuals or team(s) responsible for the creation of the EBP/innovation that may be the subject of implementation efforts | Engagement in implementation, continuous quality improvement, rapid-cycle testing, prototyping |
Innovation/EBP Characteristics | Features or qualities of innovations to be implemented | Complexity, ease of learning, cost, burden, reporting requirements | |
Innovation/EBP fit* | The extent to which the innovation/EBP fits the needs of the population served or context in which it is implemented | Innovation/EBP structural and process fit with system, organizations, providers, patients/clients | |
Bridging factors* | Community-academic partnerships* | Active partnerships between researchers and key community stakeholders, who can represent multiple levels involved in implementation (e.g., system representatives, organizational leaders, providers, consumers), that can facilitate successful implementation and delivery/use of the innovation | Community participation; partnerships; ongoing positive relationships; valuing multiple perspectives |
Purveyors/intermediaries | Organizations or individuals providing support or consultation for implementation and/or training in the innovation | Implementation readiness assessment, strategy development, training support | |
Inner Context | Organizational characteristics | Structures or processes that take place and/or exist in organizations that may influence the process of implementation | Culture; climate; readiness for change; structure; leadership; receptive context; absorptive capacity; social network support |
Leadership | Characteristics and behaviors of individuals involved in oversight and/or decision-making related to EBP implementation within an organization | Competing priorities; use of climate/culture embedding mechanisms; transformational leadership; implementation leadership | |
Quality and fidelity monitoring/support* | Processes or procedures undertaken to ensure adherence to active delivery of the innovation/EBP and/or an implementation strategy | Fidelity support system; quality assurance evaluation; continuous quality improvement | |
Organizational staffing processes | The processes or procedures in place at an organization related to the hiring, review, and retention of staff involved in the active delivery of the innovation/EBP and/or its implementation | Professional training and qualification related to EBI delivery; staff turnover | |
Individual characteristics | Shared or unique characteristics of individuals (e.g., provider, supervisor, director) that influence the process of implementation | Attitudes towards EBP; demographics and/or background; client characteristics; job demands |