Table 2 Respondents’ selections for which strategies belonged to a phase (n = 51), n (%)
Strategy number/name | Creating awareness and interest | Building knowledge and commitment | Promoting action and adoption | Pursuing integration and sustainability | p-value | |
|---|---|---|---|---|---|---|
01 | Action plan | 32 (62.8) | 34 (66.7) § | 42 (82.4) § | 32 (62.8) | 0.034 |
02 | Actionable and timely data feedback | 19 (37.3) | 26 (51.0) | 34 (66.7) § | 32 (62.8) | 0.003 |
03 | Advisory boards | |||||
04 | Announcements and broadcasts | 42 (82.4) § | 25 (49.0) | 25 (49.0) | 22 (43.1) | < 0.0001 |
-- | Annual report | 23 (45.1) | 16 (31.4) | 16 (31.4) | 3 (64.7) § | 0.0008 |
05 | Audit and feedback | 21 (41.2) | 21 (41.2) | 31 (60.8) | 35 (68.6) § | 0.003 |
06 | Audit key indicators | 21 (41.2) | 22 (43.1) | 30 (58.8) § | 33 (64.7) | 0.015 |
07 | Benchmark data | 27 (52.9) | 24 (47.1) § | 30 (58.8) | 36 (70.6) | 0.034 |
08 | Case studies | 29 (56.9) | 31(60.8) § | 31 (60.8) | 21 (41.2) | 0.056 |
09 | Celebrate local unit progress | 23 (45.1) | 25 (49.0) | 30 (58.8) | 37 (72.6) § | 0.004 |
10 | Change agents (e.g., change champion, core group, opinion leader, thought leader, etc.) | 32 (62.8) | 35 (68.6) § | 34 (66.7) § | 28 (54.9) | 0.241 |
11 | Checklist | 19 (37.3) | 22 (43.1) | 37 (72.6) § | 25 (49.0) | 0.0002 |
12 | Clinician input | 27 (52.9) | 35 (68.6) § | 32 (62.8) | 29 (56.9) | 0.102 |
13 | Cultural broker | |||||
-- | Competency metric for discontinuing training | 16 (31.4) | 20 (39.2) | 18 (35.3) | 24 (47.1) § | 0.313 |
-- | Continuing education programs | 20 (39.2) § | 36 (70.6) | 26 (51.0) | 28 (54.9) | 0.002 |
14 | Data collection by clinicians | 19 (37.3) | 24 (47.1) | 31 (60.8) § | 28 (54.9) | 0.032 |
15 | Decision algorithm | |||||
16 | Demonstrate workflow or decision algorithm | 18 (35.3) | 29 (56.9) | 34 (66.7) § | 30 (58.8) | 0.002 |
17 | Disincentives | |||||
18 | Disseminate credible evidence with clear implications for practice | 25 (49.0) | 22 (43.1) § | 28 (54.9) | 32 (62.8) | 0.10 |
19 | Distribute key evidence | 22 (43.1) § | 26 (51.0) | 25 (49.0) | 29 (56.9) | 0.419 |
20 | Documentation | 15 (29.4) | 17 (33.3) | 25 (49.0) § | 26 (51.0) | 0.014 |
21 | Education (e.g., live, virtual, or computer-based) | 27 (52.9) | 35 (68.6) § | 28 (54.9) | 22 (43.1) | 0.004 |
22 | Educational outreach or academic detailing | 23 (45.1) | 31 (60.8) § | 25 (49.0) § | 22 (43.1) | 0.116 |
23 | “Elevator speech” | 29 (56.9) | 26 (51.0) | 20 (39.2) § | 15 (29.4) | 0.001 |
-- | Financial incentives | 16 (31.4) | 13 (25.5) | 22 (43.1) | 25 (49.0) § | 0.017 |
24 | Focus groups for planning change | 23 (45.1) | 23 (45.1) § | 28 (54.9) | 22 (43.1) | 0.477 |
25 | Gaming | |||||
26 | Gap assessment/gap analysis | 27 (52.9) | 26 (51.0) § | 25 (49.0) | 18 (35.3) | 0.135 |
27 | Give evaluation results to colleagues | 18 (35.3) | 19 (37.3) | 28 (54.9) § | 31 (60.8) | 0.002 |
28 | Highlight advantages or anticipated impact | 27 (52.9) § | 27 (52.9) | 26 (51.0) | 25 (49.0) | 0.939 |
29 | Highlight compatibility | 16 (31.4) § | 21 (41.2) | 23 (45.1) | 18 (35.3) | 0.332 |
30 | Incentives | 21 (41.2) | 20 (39.2) | 28 (54.9) § | 25 (49.0) | 0.215 |
31 | Individual performance evaluation | 15 (29.4) | 17 (33.3) | 31 (60.8) § | 25 (49.0) | 0.0006 |
32 | Individualize data feedback | 15 (29.4) | 16 (31.4) | 29 (56.9) | 25 (49.0) § | 0.0016 |
33 | Inform organizational leaders | 21 (41.2) | 21 (41.2) § | 25 (49.0) | 24 (47.1) | 0.692 |
34 | Integrate practice change with other EBP protocols | 13 (25.5) | 20 (39.2) § | 29 (56.9) | 30 (58.8) | 0.0003 |
35 | Interprofessional discussion and troubleshooting | |||||
36 | Journal club | 27 (52.9) § | 32 (62.8) | 21 (41.2) | 12 (23.5) | < .0001 |
37 | Knowledge broker(s) | 26 (51.0) § | 30 (58.8) | 22 (43.1) | 14 (27.5) | 0.001 |
38 | Learning collaborative | |||||
39 | Link practice change and power holder/stakeholder priorities | 22 (43.1) | 28 (54.9) § | 28 (54.9) | 25 (49.0) | 0.373 |
40 | Link to patient/family needs and organizational priorities | 23 (45.1) | 23 (45.1) | 28 (54.9) § | 25 (49.0) | 0.521 |
41 | Local adaptation and simplify | 14 (27.5) | 16 (31.4) § | 28 (54.9) | 25 (49.0) | 0.0006 |
42 | Make impact observable | 19 (37.3) | 21 (41.2) § | 26 (51.0) | 29 (56.9) | 0.044 |
43 | Match practice change with resources and equipment | 12 (23.5) | 16 (31.4) § | 27 (52.9) | 27 (52.9) | 0.0001 |
44 | Mobile “show on the road” | 23 (45.1) § | 20 (39.2) | 21 (41.2) | 22 (43.1) | 0.861 |
-- | Multidisciplinary discussion and troubleshooting | 16 (31.4) | 25 (49.0) | 30 (58.8) § | 27 (52.9) | 0.001 |
45 | Non-punitive discussion of results | 13 (25.5) | 15 (29.4) | 25 (49.0) § | 26 (51.0) | 0.001 |
46 | Patient decision aids | 16 (31.4) | 23 (45.1) | 28 (54.9) § | 22 (43.1) | 0.032 |
47 | Patient reminders | 13 (25.5) | 16 (31.4) | 26 (51.0) § | 21 (41.2) | 0.005 |
-- | Peer influence | 24 (47.1) | 24 (47.1) | 26 (51.0) | 22 (43.1) § | 0.738 |
48 | Personalize the messages to staff (e.g., reduces work, reduces infection exposure, etc.) based on actual improvement data | 27 (52.9) | 27 (52.9) | 23 (45.1) | 20 (39.2) § | 0.322 |
49 | Pocket guides | 19 (37.3) | 22 (43.1) § | 29 (56.9) | 24 (47.1) | 0.047 |
50 | Positive deviance | |||||
51 | Posters and postings/fliers | 23 (45.1) § | 25 (49.0) | 24 (47.1) | 23 (45.1) | 0.943 |
-- | Present in educational programs | 25 (49.0) | 30 (58.8) | 28 (54.9) | 18 (35.3) § | 0.008 |
52 | Project responsibility in unit or organizational committee | 14 (27.5) | 23 (45.1) | 27 (52.9) | 26 (51.0) § | 0.004 |
53 | Provide recognition at the point of care | 15 (29.4) | 20 (39.2) | 25 (49.0) § | 26 (51.0) | 0.016 |
54 | Public recognition | 18 (35.3) | 16 (31.4) | 22 (43.1) | 27 (52.9) § | 0.013 |
55 | Publicize new equipment | 18 (35.3) § | 16 (31.4) | 27 (52.9) | 24 (47.1) | 0.010 |
56 | Reminders or practice prompts | 16 (31.4) | 20 (39.2) | 29 (56.9) § | 26 (51.0) | 0.004 |
57 | Report into quality improvement program | 11 (21.6) | 15 (29.4) | 24 (47.1) § | 25 (49.0) § | 0.0007 |
58 | Report progress and updates | 12 (23.5) | 14 (27.5) | 25 (49.0) § | 28 (54.9) | < .0001 |
59 | Report to senior leaders | 11 (21.6) | 12 (23.5) § | 22 (43.1) § | 27 (52.9) § | 0.0002 |
60 | Report within organizational infrastructure | 14 (27.5) | 18 (35.3) § | 23 (45.1) | 28 (54.9) | 0.005 |
60 | Resource manual or materials (i.e., electronic or hard copy) | 15 (29.4) | 24 (47.1) § | 28 (54.9) | 24 (47.1) | 0.011 |
61 | Resource materials and quick reference guides | 17 (33.3) | 25 (49.0) | 30 (58.8) § | 25 (49.0) | 0.010 |
62 | Quick reference guide | |||||
63 | Revise policy, procedure, or protocol | 11 (21.6) | 15 (29.4) | 24 (47.1) | 28 (54.9) § | < .0001 |
64 | Revise professional roles | |||||
65 | Role model | 18 (35.3) | 23 (45.1) | 29 (56.9) § | 27 (52.9) | 0.008 |
66 | Rounding by unit and organizational leadership | 23 (45.1) | 21 (41.2) | 29 (56.9) § | 25 (49.0) | 0.154 |
67 | Self-learning | |||||
68 | Senior executives’ announcements | 19 (37.3) § | 14 (27.5) | 21 (41.2) | 22 (43.1) | 0.207 |
69 | Share protocol revisions with clinician that are based on feedback from clinicians, patient, or family | 13 (25.5) | 19 (37.3) | 27 (52.9) | 22 (43.1) § | 0.009 |
70 | Simplify | |||||
71 | Skill competence | 11 (21.6) | 23 (45.1) | 30 (58.8) § | 20 (39.2) | < .0001 |
72 | Slogans and logos | 25 (49.0) § | 19 (37.3) | 21 (41.2) | 16 (31.4) | 0.138 |
73 | Social media influencer | |||||
74 | Sound bites | 26 (51.0) § | 16 (31.4) | 20 (39.2) | 16 (31.4) | 0.036 |
75 | Staff meetings | 25 (49.0) § | 24 (47.1) | 26 (51.0) | 23 (45.1) | 0.842 |
76 | Standing orders | 9 (17.7) | 13 (25.5) | 27 (52.9) § | 26 (51.0) | < .0001 |
-- | Strategic plan | 14 (27.5) | 15 (29.4) | 24 (47.1) | 26 (51.0) § | 0.004 |
77 | Teamwork | 26 (51.0) | 29 (56.9) § | 31 (60.8) | 29 (56.9) | 0.459 |
78 | Trend results | 16 (31.4) | 18 (35.3) | 27 (52.9) | 24 (47.1) § | 0.025 |
79 | Troubleshoot use/application | 9 (17.7) | 21 (41.2) § | 28 (54.9) | 24 (47.1) | < .0001 |
80 | Troubleshooting at the point of care/bedside | 8 (15.7) | 17 (33.3) | 27 (52.9) § | 26 (51.0) | < .0001 |
81 | Try the practice change | 11 (21.6) | 17 (33.3) | 31 (60.8) § | 21 (41.2) | < .0001 |
82 | Unit inservices | 22 (43.1) § | 27 (52.9) | 29 (56.9) | 23 (45.1) | 0.174 |
83 | Unit newsletter | 25 (49.0) § | 27 (52.9) | 25 (49.0) | 26 (51.0) | 0.932 |
84 | Unit orientation | 22 (43.1) | 24 (47.1) | 24 (47.1) § | 20 (39.2) | 0.619 |
-- | Update practice reminders | 18 (35.3) | 21 (41.2) | 24 (47.1) | 28 (54.9) § | 0.033 |
85 | Visit other sites | |||||