Table 1 Examples of proposed implementation strategies and intended outcomes by professional role and implementation phase.
From: Learning from scaling up ultra-rapid genomic testing for critically ill children to a national level
Role/phase | Priority by Consolidated Framework for Implementation Research (CFIR) code—domain/construct | For example, | Proposed implementation strategy for future implementation taken from the Expert Recommendations for Implementing Change (ERIC)33 taxonomy | For example | Proposed outcome I = implementation H = Health S = Service |
|---|---|---|---|---|---|
All | Inner setting/networks and communication | Building relationships | Develop stakeholder relationships | Regular communication and feedback with the team. Build external relationships | I: Penetration I: Sustainability |
Genetic counselors | Process/executing | Ensuring local processes meet the ultra-rapid time constraints | Support clinicians/change infrastructure | Experienced genetic counselors mentor those new to ultra-rapid genomics | I: Fidelity |
Clinical geneticists | Intervention characteristics/design quality and packaging | Patient centred program design | Evaluation and iterative strategies (audit and feedback) | Transparent and regular feedback on clinical outcomes | S: Effectiveness |
Intensivists | Inner setting/access to knowledge | Access to genomic knowledge | Revise professional roles | Upskill compatible non-genetic medical specialists e.g., endocrinologists/neurologists | I: Feasibility |
Pre-implementation | Intervention characteristics/relative advantage | Getting rapid answers for families | Engage consumers | Development of a family report | I: Acceptability |
Mid-implementation | Characteristics of individuals/other personal attributes | Motivation | Develop stakeholder relationships | Support local champions | I: Sustainability |
Sustainability | Inner setting/available resources | Access to counseling | Adapting and tailoring to context | Use of telehealth | I: Penetration |
