Table 3 i-PARIHS context construct characteristics, context subcodes, and definitions
From: Development of a qualitative data analysis codebook informed by the i-PARIHS framework
Characteristics of context by level [7] | Context subcodes | Context subcode definitions |
|---|---|---|
Inner/local: formal and informal leadership support Inner/organizational: leadership and senior management support | Leadership support | Characteristics or behaviors of formal or informal leaders that either support or interfere with the implementation or sustainment of the innovation. This could include discussion of leadership style, relationship building, role modeling, educating, planning-organizing-aligning, communicating, encouraging, empowering, and/or concrete support, e.g., protected time, space, resources, training. Alternatively, the discussion may be about how leaders fail to provide such support or exhibit negative attitudes/behaviors toward innovation implementation/sustainment. |
Inner/local: culture Inner/organizational: culture | Culture and climatea | Culture of the organization or organizational unit, including prevailing norms, values, beliefs, meanings, understandings, philosophies, way of life, and assumptions. It also includes discussion about the current climate of the organization or organizational unit, e.g., staff empowerment, morale, attitudes, job satisfaction, and burnout, as well as the degree of stability/instability of the environment in which implementation is occurring/will occur. |
Inner/local: past experiences with innovation/change Inner/organizational: history of innovations and change | History of innovation and change | How the organization or organizational unit has historically experienced, undertaken, and responded to past change initiatives and/or innovations. |
Inner/local: evaluation and feedback processes | Evaluation, monitoring, and feedbacka | How the organization or organizational unit collects, assesses, monitors, and disseminates data/information about clinical processes and outcomes, economic outcomes, user experiences, clinical performance, etc. It also includes discussion about data sources (e.g., data dashboards, medical records) and ways in which results are fed back to and used by individuals, teams, and services (e.g., through presentations and/or formal reports). This information may be used, e.g., to understand current ways of working or to improve processes. |
Inner/organizational: organizational priorities Outer: policy drivers and priorities and regulatory frameworks | Policies and prioritiesa (includes mandates) | Organizational policies, policy drivers, mandates, and/or priorities; whether/how these are related to/support/hinder the innovation and/or its implementation; and the changes required. Policies are the decisions, plans, and actions that an organization, organizational unit, state, or country takes to achieve specific goals. They include statements of what needs to happen and how (e.g., legislation enacted by a government, regulations or rules issued to carry out the intent of laws or of regulatory bodies, regulatory frameworks or models for enacting regulations, and organizational policies and procedures). Policy drivers are forces that influence policy decisions, e.g., serious problems, i.e., high rates of suicide; legal or ethical concerns, i.e., lack of equity; and crisis events, i.e., hurricanes and forest fires. Mandates are formal orders/commands/requirements and may be a component of written policies. Organizational priorities are identified areas of focus, e.g., improving access to care and reducing medical errors in healthcare settings. |
Inner/organizational: learning networks Outer: interorganizational networks and relationships | Networks and relationships | Formal or informal networks and/or relationships that may be/have been leveraged to support or hinder implementation. Networks/relationships may be professional, task-related, or social and may occur at any level or across levels of the context. Examples of formal networks/relationships include memberships, listservs, communities of practice, learning communities, learning collaboratives, and practice-based research networks. Examples of informal networks/relationships include social practices such as getting together with colleagues for lunch, regular hallway conversations with certain colleagues, friendships, and “huddles” among clinical providers/teams. |
Inner/organizational: structures and systems | Structures and systems | Formal and informal ways in which the organization or organizational unit is structured and managed and/or its processes for accomplishing work. Examples of structure include authority hierarchies (e.g., chain of command), service lines, matrices, specialized or functional units or departments, inter-/multi-disciplinary teams and task forces, and decision-making levels represented in organizational charts. Although structure and systems are not always distinct, systems generally are related to organizational routines and processes, e.g., for information sharing, learning, workflow, and IT. |
Inner/organizational: absorptive capacity | Absorptive capacity | How the organization or organizational unit (e.g., department or clinic) identifies, acquires, assimilates, transforms, and/or applies new, valuable knowledge (e.g., evidence, guidelines, best practices). This includes analyzing, processing, interpreting, understanding, combining with existing knowledge, and applying/incorporating new knowledge into organizational competencies and routines. |
Outer: incentives and mandates | Incentives and rewardsa | Mechanisms/strategies that motivate/encourage/reinforce or that deter/discourage the implementation of the innovation and proposed changes, including incentives/rewards (e.g., casual dress day, pizza day, time off, recognition, financial incentives, i.e., pay for performance) and disincentives (e.g., negative performance reviews, reprimands, regulatory requirements). |
N/A | Infrastructure, resources, and supportb | Presence or absence of infrastructure (e.g., facilities, space, equipment, transportation), resources (e.g., funding, staffing, time, education, skills training, materials), and/or support (e.g., supervisory, clerical) for implementing the innovation. |
N/A | Political factors and dynamicsb | Organizational politics, i.e., how individuals or groups use political strategies to gain/use power and/or social influence in order to positively or negatively affect decisions and activities related to the adoption or implementation of an innovation. For example, they might create conflict, form alliances, bargain, use stalling tactics, discredit others, or compromise. If relevant, this code also includes discussion about the larger political environment (e.g., state or national government) and prevailing political ideology (e.g., nationalism, populism) as it relates to innovation implementation. |
Inner/local: mechanisms for embedding changec | N/A | |
Outer: environmental stabilityc | N/A |