Publication date: 25 February 2026

Authors: Caci, L, Blum, K, Johnson, C, Albers, A, Clack, L

Journal: Implementation Science Communications

Title: Organizational Readiness for Implementing Infection Control in European Hospitals: Insights from Coincindence Analysis.

Abstract:

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Publication date: 23 October 2025

Authors: Albers, B., Caci, L., Blum, K., Boland, G., Carrara, E., Retamar Gentil, P., Nguyen, A., Pollard, J., Schechner, V., Sonpar, A., Yanagida, T., Zingg, W., and Clack, L.

Journal: Trials

Title: Examining tailoring as an implementation strategy for reducing healthcare-associated infections across European acute care hospitals (REVERSE): study protocol for a hybrid type 2 effectiveness-implementation trial.

Abstract:

Link(s): https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-025-09132-x

File(s): Protocol_Trials.pdf

Publication date: 15 May 2025

Authors: Caci, L, Nyantakyi, E, Blum, K., Sonpar, A., Schultes, M.-T., Albers, B., Clack, L.

Journal: Implementation Research and Practise

Title: Organizational Readiness for Change: A Systematic Review of Healthcare Literature

Abstract: BackgroundOrganizational readiness for change (ORC), referring to psychological and behavioral preparedness of organizational members for implementation, is often cited in healthcare implementation research. However, evidence about whether and under which conditions ORC is relevant for positive implementation results remains ambiguous, with past studies building on various theories and assessing ORC with different measures. To strengthen the ORC knowledge base, we therefore identified factors investigated in the empirical literature alongside ORC, or as mediators and/or moderators of ORC and implementation.MethodWe conducted a systematic review of experimental, observational, and hybrid studies in physical, mental, and public health care that included a quantitative assessment of ORC and at least one other factor (e.g., ORC correlate, predictor, moderator, or mediator). Studies were identified searching five online databases and bibliographies of included studies, employing dual abstract and full text screening. The study synthesis was guided by the Consolidated Framework for Implementation Research integrated with the Theory of ORC. Study quality was appraised using the Mixed Methods Appraisal Tool.ResultsOf 2,907 identified studies, 47 met inclusion criteria, investigating a broad range of factors alongside ORC, particularly contextual factors related to individuals and the innovation. Various ORC measures, both home-grown or theory-informed, were used, confirming a lack of conceptual clarity surrounding ORC. In most studies, ORC was measured only once.ConclusionsThis systematic review highlights the broad range of factors investigated in relation to ORC, suggesting that such investigation may enhance interpretation of implementation results. However, the observed diversity in ORC conceptualization and measurement supports previous calls for clearer conceptual definitions of ORC. Future efforts should integrate team-level perspectives, recognizing ORC as both an individual and team attribute. Prioritizing the use of rigorous, repeated ORC measures in longitudinal implementation research is essential for advancing the collective ORC knowledge base.

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Publication date: 19 March 2025

Authors: J. Pollard, E. Agnew, N. Pearce-Smith, K.B. Pouwels, N. Salant, J.V. Robotham

Journal: The Journal of Hospital Infection

Title: Umbrella review of economic evaluations of interventions for the prevention and management of healthcare-associated infections in adult hospital patients

Abstract:

Link(s): https://www.journalofhospitalinfection.com/article/S0195-6701(25)00009-X/fullte…

File(s): Umbrella Review

Publication date: 12 December 2024

Authors: Albers, B., Verweij, L., Blum, K., Oesch, S., Schultes, M.-T., Clack, L., Naef, R.

Journal: Implementation Science

Title: Firm, yet Flexible: a Fidelity Debate Paper with Two Case Examples

Abstract:  BACKGROUNDIn healthcare research and practice, intervention and implementation fidelity represent the steadfast adherence to core components of research-supported interventions and the strategies employed for their implementation. Evaluating fidelity involves determining whether these core components were delivered as intended. Without fidelity data, the results of complex interventions cannot be meaningfully interpreted. Increasingly, the necessity for firmness and strict adherence by implementers and their organizations has been questioned, with calls for flexibility to accommodate contextual conditions. This shift makes contemporary fidelity a balancing act, requiring researchers to navigate various tensions. This debate paper explores these tensions, drawing on experiences from developing fidelity assessments in two ongoing effectiveness-implementation hybrid trials.MAIN BODYFirst, given often scarce knowledge about the core components of complex interventions and implementation strategies, decisions about fidelity requirements involve a degree of subjective reasoning. Researchers should make these decisions transparent using theory or logic models. Second, because fidelity is context-dependent and applies to both interventions and implementation strategies, researchers must rethink fidelity concepts with every study while balancing firmness and flexibility. This is particularly crucial for hybrid studies, with their differing emphasis on intervention and implementation fidelity. Third, fidelity concepts typically focus on individual behaviors. However, since organizational and system factors also influence fidelity, there is a growing need to define fidelity criteria at these levels. Finally, as contemporary fidelity concepts prioritize flexible over firm adherence, building, evaluating, and maintaining fidelity in healthcare research has become more complex. This complexity calls for intensified efforts to expand the knowledge base for pragmatic and adaptive fidelity measurement in trial and routine healthcare settings.CONCLUSIONContemporary conceptualizations of fidelity place greater demands on how fidelity is examined, necessitating the expansion of fidelity frameworks to include organizational and system levels, the service- and study-specific conceptualizations of intervention and implementation fidelity, and the development of pragmatic approaches for assessing fidelity in research and practice. Continuing to build knowledge on how to balance requirements for firmness and flexibility remains a crucial task within the field of implementation science.

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