Learning Health Systems
Consolidated Framework for Implementation Research (CFIR) Mapping and Visualization of Pre‐Implementation Determinants for Sepsis Care Transitions
By Sang Bin You, Michael A. Stawnychy, Jiyoun Song and 8 others.
Abstract
ABSTRACT Introduction High‐quality care transitions are essential for sepsis survivors at risk of readmission and long‐term complications. These complex innovations require coordination across organizations, individuals, and processes. The Consolidated Framework for Implementation Research (CFIR) offers a systematic approach to identifying multi‐level implementation determinants, but translating them into actionable strategies remains challenging. This study examines the representation of implementation determinants across CFIR domains and visualizes their cross‐domain interconnectedness. Methods CFIR‐guided, semi‐structured pre‐implementation needs assessment interviews were conducted with stakeholders involved in sepsis care transitions across five hospital‐home healthcare (HHC) dyads. Thirty‐two themes identified through deductive‐inductive coding were mapped to CFIR domains and constructs and visualized using node diagrams. Results Sixty‐one interviews with 91 stakeholders identified 32 themes spanning all five CFIR domains, with most themes mapping to multiple domains. Access to Care theme mapped across all five domains, while External Policies and Incentives and Informal Caregiving themes were represented only once. Implementation Process domain was most represented and Innovation least represented. All constructs within the Implementation Process and Individual Characteristics domains were captured. Node diagrams illustrated the depth and interconnected influence of determinants in sepsis care transitions. Conclusions Stakeholders identified complexity emerged across technical, structural, and policy domains as both an innovation feature and contextual determinants of sepsis care transitions. CFIR mapping and visualization provided a structured approach to characterizing pre‐implementation complexity in sepsis care transitions. Examining determinant representation and cross‐domain interconnectedness may help identify cross‐cutting, potentially high‐leverage implementation needs and inform strategy selection and tailoring for complex hospital‐to‐home interventions.



