Tools that Guide Your Implementation

The Atlas Initiative is developing tools to guide health care facilities and health systems through successful implementation of quality improvement projects. Health care stakeholders can be more effective when they have a better understanding of how to adapt and support health care innovations across diverse environments. Atlas helps systems assess their readiness for an implementation project and make changes to support success.

The Challenge

Health systems everywhere continually look for ways to improve patient care. But when implementing solutions for health care’s biggest challenges, we know one size does not fit all. A solution that succeeds in one location can completely fail in a different setting. Why is that?

Health systems’ culture and operations may vary, making solutions effective in one place but not others. It can be difficult to determine which factors will lead to successful implementation.   

When health systems are able to first assess and address key factors, such as implementation skills, leadership commitment, staff motivation, and competing priorities, they are more likely to be successful when implementing a quality improvement program. 

Our Strategy

Atlas has created, and is currently testing, a suite of evidence-informed tools that will enable hospitals and health systems to assess facility-specific implementation factors. The toolkit includes a set of surveys and supporting materials that aim to improve implementation success. Any facility that has defined a problem affecting patient care and identified a potential solution to address the problem can use this toolkit.

Surveys are administered electronically, and aggregate results are provided back to users. The context assessment can be used at the department, clinic, or unit level as well as throughout an organization. These resources help to inform whether a site is ready to implement a solution, what resources are needed to support implementation, and what decisions need to be made about implementation strategies or adaptations to the  intervention to align with the site’s strengths and challenges.

The Toolkit contains:

  • The Pre-Implementation Survey: A survey to assess a site’s context to address an area for improvement (before an intervention has been selected or before staff are familiar with the intervention).
  • The Foundation Survey: An early-implementation survey to assess key contextual factors that may impact a specific intervention.
  • The Progress Survey: Completed during implementation to identify any needed changes to the implementation strategy.
  • The Pulse-Check Survey: Used regularly during an ongoing implementation to track aspects of implementation that could jeopardize success.

Atlas is also developing a data repository that will identify the contextual factors that most influence implementation success while providing contributors with a report of their site’s strengths and challenges for implementation. Currently under construction, this database will allow the Atlas team to conduct several analyses of interest and importance to the quality improvement and health care implementation community. Potential analyses include: identifying how the importance of contextual factors varies by types of interventions, health care settings, and implementation time points; establishing benchmarks for contextual factors among high success implementers; and assessing how use of context assessment reports affects implementation success.