Table 1 Assessing PRISM domains to understand context for implementation
PRISM domain | What we are assessing | Data collection techniques |
|---|---|---|
Organization perspectives and values | - Staff perspectives evidence base - Staff perspectives usefulness in local context - Current workflow processes - How each EBP fits into the broader organization - Potential contextual factors that may facilitate/limit implementation - Job satisfaction | - Key informant interviews - Site visit rapid ethnography observations - Staff process mapping - Brainwriting activity - VA all employee surveys (for example SAIL ratings) |
Patient perspective and values | - Veteran perspectives on key intervention components - Overall program satisfaction with care - Identify potential unmet needs | - Site visit rapid ethnography observations - Veteran Advisory Board feedback - SAIL metrics |
Organizational recipient characteristics | - Existing quality gaps documented by data and as perceived by staff - Organizational priorities as perceived by frontline staff and leaders - Staffing and turnover - Interfacility communication - Existing quality improvement initiatives | - National level VA quantitative data - VA all employee surveys - Key informant interviews - Brainwriting activity |
Patient recipient characteristics | - Sociodemographic characteristics - Health status - Competing programs or demands on patients - Stories of patients who could be impacted by AFHS - Overall program satisfaction with care | - National level VA quantitative data - Site visit rapid ethnography observations - Veteran Advisory Board feedback |
Implementation and sustainability infrastructure | - Existing processes and systems - Prior experience with new initiatives - Culture regarding satisfaction with work and new initiatives - Relationships between key stakeholders - Resources for implementation and sustainment - Staff readiness to change | - Key informant interviews - Brainwriting activity - Staff process mapping |
External environment | - Current regulatory environment as perceived by staff/leaders - Changes in organization due to external changes (MISSION, changing patient population, reimbursement) - Existing guidelines or incentives | - Key informant interviews - Brainwriting activity - Review of artifacts - VA all employee surveys - National level VA quantitative data |