**PARIHS Framework (Promoting Action on Research Implementation in Health Services)** [[Implementation Science Theories and Frameworks]] The **PARIHS Framework** (Promoting Action on Research Implementation in Health Services) is a conceptual model designed to enhance the implementation of research findings into clinical practice. Developed in the late 1990s by Alison Kitson and her colleagues, the framework emphasizes the interplay between three core elements: **evidence**, **context**, and **facilitation**. (https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-3-1) ---- ## Core Elements of the PARIHS Framework 1. **Evidence**: - This encompasses various forms of knowledge that can inform practice, including: - **Research Evidence**: Ranging from anecdotal to robust randomized controlled trials (RCTs). - **Clinical Experience**: Insights gained from healthcare professionals' experiences. - **Patient Preferences**: Involvement and feedback from patients regarding their care. - **Local Information**: Data specific to the local healthcare environment. 2. **Context**: - The environment where implementation occurs, characterized by: - **Culture**: The prevailing attitudes and beliefs within the organization. - **Leadership**: The support and direction provided by organizational leaders. - **Evaluation Systems**: Mechanisms for assessing performance and outcomes. [[202410250855 How does evaluation systems influence implementation]] 3. **Facilitation**: - Refers to the support provided to implement change effectively, which includes: - **Characteristics of Facilitators**: Attributes such as credibility, respect, and empathy. - **Roles**: Clarity in the responsibilities of those facilitating change. - **Style**: The approach taken by facilitators, which should be flexible and consistent. ## Implementation Success Successful implementation is more likely when: - The evidence is robust and aligns with professional consensus and patient needs. - The context is conducive to change, featuring supportive leadership and a positive culture. - Effective facilitation mechanisms are in place to guide the process[1][2][4]. ## Evolution of the Framework The original PARIHS framework has evolved into the **i-PARIHS framework**, which integrates additional theoretical underpinnings and practical tools aimed at enhancing its application in complex healthcare settings. This evolution emphasizes that successful implementation is not linear but rather a dynamic interaction among the elements[3]. ## Practical Application The PARIHS framework serves as a diagnostic tool for clinicians and researchers, helping them identify factors that may hinder or facilitate the implementation of evidence-based practices. It has been widely referenced in literature related to quality improvement and evidence-based practice in healthcare settings[2][4]. In summary, the PARIHS Framework provides a comprehensive approach to understanding and improving the implementation of research findings into practice by considering multiple interacting factors that contribute to success. Citations: [1] https://sites.bu.edu/ciis/files/2016/06/qi-041409-part1.pdf [2] https://downloads.lww.com/wolterskluwer_vitalstream_com/journal_library/ncq_10573631_2004_19_4_297.pdf [3] https://pmc.ncbi.nlm.nih.gov/articles/PMC7310499/ [4] https://researchimpact.ca/archived/the-parihs-framework-promoting-action-on-research-implementation-in-health-services/ [5] https://pmc.ncbi.nlm.nih.gov/articles/PMC6893845/ [6] https://www.researchgate.net/publication/5670027_Evaluating_the_successful_implementation_of_evidence_into_practice_using_the_PARIHS_framework_Theoretical_and_practical_challenges