Survey introduction | Pilot version | Version used in initial Think Aloud interviewsa | Final version of pCAT | |||
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Question Stem (open-text response): | Please enter your problem area (area for improvement). This should reflect whatever topic you and your team are currently considering. It does not have to be final (e.g., The majority of patients fail to show up for scheduled orientation) | Please enter your problem area (area for improvement). This should reflect whatever topic you and your team are currently considering. It does not have to be final (e.g., The majority of patients fail to show up for scheduled orientation) | We’ve found that it’s best to think concretely about a planned or on-going implementation (as opposed to the more general implementation environment). Include the specifics of the implementation/improvement project here | |||
Identifying Barriers vs. Facilitators (item responses): | Overall, we are most likely to encounter more (check only one): 1 = Facilitating forces related to [construct] 2 = Hindering forces related to [construct] 3 = We cannot think of any facilitating or hindering forces related to [construct] | 1 = Disagree 2 = Neutral 3 = Agree | 1 = Disagree: This means the item is a potential barrier 2 = Neutral 3 = Agree: This means the item is a potential facilitator | |||
Effect on implementation (item responses): | 1 = Weak 2 = Moderate 3 = High | 1 = Low impact 2 = Moderate impact 3 = High impact | 0 = Weak/no effect 1 = Strong effect | |||
CFIR-based survey items | ||||||
CFIR domain | CFIR construct | Short definition | Survey version 1.0 | Survey version 2.0 | Final survey | |
Program Characteristics | Relative Advantage | Stakeholders’ perception of the advantage of implementing the intervention versus an alternative solution | The extent to which leaders and staff recognize the potential benefit of implementing a change to address your problem area, especially compared to other alternatives, may influence your success | Key people will see the advantage of implementing the change versus an alternative | People here see the advantage of implementing the change versus an alternative | |
Outer Setting | Patient Needs & Resources | The extent to which patient needs, as well as barriers and facilitators to meet those needs are accurately known and prioritized by the organization | The extent people are aware of Veteran needs and preferences and use that information to improve programs may influence your success | People here regularly seek to understand the needs of patients and make changes to better meet those needs | [NO CHANGE from version used in Think Aloud interviews] People here regularly seek to understand the needs of patients and make changes to better meet those needs | |
Inner Setting | Structural Characteristics | The social architecture, age, maturity, and size of an organization | The structural characteristics, including the age, size, how people and processes are organized, hierarchical structure, policies and procedures may influence your success | The structures and policies in place here will enable us to make the change | [NO CHANGE from version used in Think Aloud interviews] The structures and policies in place here enable us to make the change | |
 | Networks & Communications | The nature and quality of webs of social networks and the nature and quality of formal and informal communications within an organization | Quality and type of working relationships between people and the quality of communications may influence your success | I have open lines of communication with everyone needed to make the change | [NO CHANGE from version used in Think Aloud interviews] I have open lines of communication with everyone needed to make the change | |
 | Tension for Change | The degree to which stakeholders perceive the current situation as intolerable or needing change | The degree to which stakeholders perceive the current situation as intolerable or needing change may influence your success | Key people will see the current situation as intolerable and that the change is needed | People here see the current situation as intolerable and that the change is needed | |
 | Compatibility | The degree of tangible fit between meaning and values attached to the intervention by involved individuals, how those align with individuals’ own norms, values, and perceived risks and needs, and how the intervention fits with existing workflows and systems | The level of compatibility between the change you might implement and (1) existing workflows and systems; and (2) norms, values, and perceived risks and needs in your facility, may influence your success | The change is compatible with existing clinical processes | [NO CHANGE from version used in Think Aloud interviews] The change is compatible with existing clinical processes | |
 |  |  |  | The change is aligned with clinician values related to weight loss among Veterans | [NO CHANGE from version used in Think Aloud interviews] The change is aligned with clinician values related to weight loss among Veterans | |
 | Goals & Feedback | The degree to which goals are clearly communicated, acted upon, and fed back to staff and alignment of that feedback with goals | The extent leaders clearly communicate goals and provide helpful feedback, as well as the extent feedback aligns with organizational and clinical goals, may influence your success | The change is aligned with leadership goals | [NO CHANGE from version used in Think Aloud interviews] The change is aligned with leadership goals | |
 | Learning Climate | A climate in which: (a) leaders express their own fallibility and need for team members’ assistance and input; (b) team members feel that they are essential, valued, and knowledgeable partners in the change process; (c) individuals feel psychologically safe to try new methods; and (d) there is sufficient time and space for reflective thinking and evaluation | The extent to which people feel encouraged to experiment, look for ways to improve current processes and programs, and learn from mistakes may influence your success | Not assessed | Not assessed | |
 | Leadership Engagement | Commitment, involvement, and accountability of leaders and managers with the implementation | The level of commitment and involvement of leaders in your charter aim may influence your success | Leaders here will be committed, involved, and accountable for the planned improvement | Higher level leaders are committed, involved, and accountable for the planned improvement | |
Leaders I work with most closely are committed, involved, and accountable for the planned improvement | ||||||
 | Available Resources | The level of resources dedicated for implementation and on-going operations including money, training, education, physical space, and time | The level of resources available to support your charter aim, including money, physical space, and time, may influence your success | We will have sufficient time dedicated to make the change | We have sufficient time dedicated to make the change | |
 |  |  |  | We will have sufficient space to accommodate the change | We have sufficient space to accommodate the change | |
 |  |  |  | We will have other needed resources to make the change | We have other needed resources to make the change | |
Process | Reflecting & Evaluating | Quantitative and qualitative feedback about the progress and quality of implementation accompanied with regular personal and team debriefing about progress and experience | Not assessed | I have access to data to help track changes in outcomes | [NO CHANGE from version used in Think Aloud interviews] I have access to data to help track changes in outcomes |