--- title: "Framework: research on implementation of process redesign | Sutter Health" description: "Process redesign framework developed for AHRQ adds 2 domains and new constructs to the Consolidated Framewk for Implementation Research." url: "https://www.sutterhealth.org/research/publications/framework-research-on-implementation-of-process-redesign-1055312348" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Framework: research on implementation of process redesign # Framework for research on implementation of process redesigns. Ashok M, Hung D, Rojas-Smith L, Halpern MT, & Harrison M. _Qual Manag Health Care. 27(1):17-23. doi: 10.1097/QMH.0000000000000158._ 2018-01-01 ## Abstract BACKGROUND: Complex system interventions benefit from close attention to factors affecting implementation and resultant outcomes. This article describes a framework for examining these factors in process redesign (PR) and for assessing PR outcomes. METHODS: Using literature scans and expert comment on draft frameworks based on the Consolidated Framework for Implementation Research, a team of researchers developed the PR framework for the Agency for Healthcare Research and Quality. As a case study, an independent team of researchers in a large care system subsequently applied the PR framework to implementation of Lean-based primary care redesigns. RESULTS: The PR framework adds 2 domains to the Consolidated Framework for Implementation Research, focused on relevant measures of implementation and outcomes, as well as some new constructs to the Consolidated Framework for Implementation Research. Using the PR framework to guide a study of primary care PR, researchers found that the health care reform environment encouraged staff recognition of need for redesign, but physicians worried about key redesign issues, including collocation with care team partners and the competencies of the individuals assigned to manage new workflows. Team member acceptance of the redesign was also influenced by other features of the implementation process and contextual features, including the decision style of the local clinic. CONCLUSIONS: The PR framework helped guide the qualitative study and aided researchers in informing their leadership about critical issues affecting PR implementation. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/29280903) ## Research topics - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [The language of engagement: "aha!" moments from engaging patients and community partners in two pilot projects of the Patient-Centered Outcomes Research Institute.](https://www.sutterhealth.org/research/publications/engaging-pts-community-two-pcori-pilot-projects-1055312382) Tai-Seale M, Sullivan G, Cheney A, Thomas K, Frosch D. Perm J. 20(2). doi: 10.7812/TPP/15-123. \[Epub ahead of print\] 2016 Feb 22 - Publication ### [Implementation of care management: an analysis of recent AHRQ research.](https://www.sutterhealth.org/research/publications/care-mgmt-implementation-ahrq-research-1055312536) Tomoaia-Cotisel A, Farrell TW, Solberg LI, Berry CA, Calman NS, Cronholm PF, Donahue KE, Driscoll DL, Hauser D, McAllister JW, Mehta SN, Reid RJ, Tai-Seale M, Wise CG, Fetters MD, Holtrop JS, Rodriguez HP, Brunker CP, McGinley EL, Day RL, Scammon DL, Harrison MI, Genevro JL, Gabbay RA, Magill MK. Med Care Res Rev. 2016 Oct 20. pii: 1077558716673459. \[Epub ahead of print\] 2016 Oct 20 - Publication ### [The public's opinions of physicians: do perceived choice and exercised choice matter?](https://www.sutterhealth.org/research/publications/public-opinion-mds-perceived-exercised-choice-1055312570) Tai-Seale M, Pescosolido B. Am J Manag Care. 9(9):631-8. 2003 Sep 01 - Publication ### [Shared decision-making for syncope in the emergency department: a randomized controlled feasibility trial.](https://www.sutterhealth.org/research/publications/shared-decision-making-for-syncope-in-er-1055312729) Probst MA, Lin MP, Sze J, Hess EP, Breslin M, Frosch DL, Sun BC, Langan MN, Thiruganasambandamoorthy V, Richardson LD. Acad Emerg Med. doi: 10.1111/acem.13955. \[Epub ahead of print\] 2020 Mar 09 - Publication ### [Estimating the human resource costs of developing and implementing shared medical appointments in primary care.](https://www.sutterhealth.org/research/publications/hr-costs-shared-med-appts-primary-care-1055312455) Stults CD, McClellan S, Panattoni L, Mazza MC, Tai-Seale M. J Ambul Care Manage. 39(1):23-31. 2016 Jan 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/framework-research-on-implementation-of-process-redesign-1055312348#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Framework: research on implementation of process redesign"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/framework-research-on-implementation-of-process-redesign-1055312348#medicalscholarlyarticle","name":"Framework for research on implementation of process redesigns.","headline":"Framework: research on implementation of process redesign","abstract":"BACKGROUND: Complex system interventions benefit from close attention to factors affecting implementation and resultant outcomes. This article describes a framework for examining these factors in process redesign (PR) and for assessing PR outcomes. METHODS: Using literature scans and expert comment on draft frameworks based on the Consolidated Framework for Implementation Research, a team of researchers developed the PR framework for the Agency for Healthcare Research and Quality. As a case study, an independent team of researchers in a large care system subsequently applied the PR framework to implementation of Lean-based primary care redesigns. RESULTS: The PR framework adds 2 domains to the Consolidated Framework for Implementation Research, focused on relevant measures of implementation and outcomes, as well as some new constructs to the Consolidated Framework for Implementation Research. Using the PR framework to guide a study of primary care PR, researchers found that the health care reform environment encouraged staff recognition of need for redesign, but physicians worried about key redesign issues, including collocation with care team partners and the competencies of the individuals assigned to manage new workflows. Team member acceptance of the redesign was also influenced by other features of the implementation process and contextual features, including the decision style of the local clinic. 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