Background:
Greenhalgh et al. used a considerable evidence-base to develop a comprehensive model ofimplementation of innovations in healthcare organizations [1]. However, these authors didnot fully operationalize their model, making it difficult to test formally. The present paperrepresents a first step in operationalizing Greenhalgh et al.’s model by providing background,rationale, working definitions, and measurement of key constructs.
Methods:
A systematic review of the literature was conducted for key words representing 53 separatesub-constructs from six of the model’s broad constructs. Using an iterative process, wereviewed existing measures and utilized or adapted items. Where no one measure wasdeemed appropriate, we developed other items to measure the constructs through consensus.
Results:
The review and iterative process of team consensus identified three types of data that canbeen used to operationalize the constructs in the model: survey items, interview questions,and administrative data. Specific examples of each of these are reported.
Conclusion:
Despite limitations, the mixed-methods approach to measurement using the survey, interviewmeasure, and administrative data can facilitate research on implementation by providinginvestigators with a measurement tool that captures most of the constructs identified by theGreenhalgh model. These measures are currently being used to collect data concerning theimplementation of two evidence-based psychotherapies disseminated nationally withinDepartment of Veterans Affairs. Testing of psychometric properties and subsequentrefinement should enhance the utility of the measures.