What is EPIS used for?
A framework for understanding implementation as a sequence of phases over time.
Key points: * Exploration * Preparation * Implementation * Sustainment. In practice: EPIS answers “where are we now?”
What mistake do teams make when they ignore phases?
They apply the same strategies regardless of timing.
Key points: * Premature rollouts * Late engagement * Missed foundations. In practice: Good strategies fail when mistimed.
What defines the Exploration phase?
Deciding whether and why to implement an intervention.
Key points: * Problem clarification * Fit assessment * Stakeholder scanning. In practice: Exploration is about sense-making, not execution.
What should not happen in Exploration?
Detailed rollout planning.
Key points: * No timelines yet * No performance targets yet. In practice: Planning too early locks in bad assumptions.
What key question defines Exploration success?
“Is this worth doing here, now?”
Key points: * Strategic alignment * Local relevance. In practice: Skipping this creates downstream resistance.
What defines the Preparation phase?
Building the conditions needed for implementation to work.
Key points: * Workflow design * Role clarification * Resource alignment. In practice: Preparation is invisible when done well.
Why is Preparation often underestimated?
Because its outputs are not immediately visible.
Key points: * No “launch” moment * Mostly design work. In practice: Weak preparation shows up as chaos later.
What is a sign you’re rushing out of Preparation?
Unresolved questions about ownership and workload.
Key points: * “We’ll figure it out later” * Reliance on champions. In practice: Unanswered questions become failure points.
What defines the Implementation phase?
Initial use of the intervention in real settings.
Key points: * Learning by doing * Rapid feedback. In practice: Implementation is about adjustment, not perfection.
What should teams expect during Implementation?
Variation, friction, and surprises.
Key points: * Uneven uptake * Workarounds. In practice: Early instability is normal, not failure.
Why is monitoring critical during Implementation?
Because early signals guide adaptation.
Key points: * Fidelity * Feasibility * Acceptability. In practice: Don’t wait for outcomes to adjust.
What defines the Sustainment phase?
When the intervention becomes routine practice.
Key points: * No active support * Survives turnover. In practice: If it needs chasing, it’s not sustained.
Why is Sustainment not “Implementation, but later”?
Because the determinants change.
Key points: * Memory replaces motivation * Systems replace champions. In practice: What worked early often fails later.
What commonly kills Sustainment?
Loss of ownership.
Key points: * Project teams exit * No permanent home. In practice: Handover is a high-risk moment.
How do phases interact with each other?
Weak early phases amplify problems later.
Key points: * Poor exploration → misfit * Poor preparation → overload. In practice: You always pay for skipped phases.
Can teams move backwards in EPIS?
Yes — phases are not strictly linear.
Key points: * Re-exploration may be needed * Re-preparation after adaptation. In practice: Going back is correction, not failure.
Why do strategies need to change by phase?
Because the dominant problems change over time.
Key points: * Early: fit and buy-in * Mid: usability and workload * Late: routinisation. In practice: Static strategy is a warning sign.
What is a classic Exploration-phase failure?
Assuming the problem is already agreed upon.
Key points: * Different stakeholders, different problems * Misaligned expectations. In practice: Unspoken disagreement resurfaces later.
What is a classic Preparation-phase failure?
Leaving workflow impacts implicit.
Key points: * Hidden workload * Role ambiguity. In practice: Ambiguity becomes resistance.
What is a classic Implementation-phase failure?
Treating early problems as non-compliance.
Key points: * Over-policing * Under-learning. In practice: Early use is diagnostic data.
What is a classic Sustainment-phase failure?
Assuming success will persist on its own.
Key points: * No institutionalisation * No ownership. In practice: Success decays quietly.
How does EPIS help with prioritisation?
By clarifying what matters now.
Key points: * Not all problems are urgent * Not all fixes are timely. In practice: Phase clarity reduces noise.
Why is EPIS useful for OHFE work?
Because it aligns design effort with timing.
Key points: * HF insights land differently by phase * Early vs late redesign. In practice: Right insight, wrong time still fails.
How does EPIS complement CFIR?
CFIR diagnoses what; EPIS clarifies when.
Key points: * CFIR = content * EPIS = timing. In practice: Together, they guide action sequencing.
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*MASTER 101101
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*Intervention vs Implementation Mapping84
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*Implementation Frameworks — What’s in the Box?75
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Refresher102
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CFIR56
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1 What Implementation Science Is (and Is Not)30
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2 Core Implementation Mental Models30
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3 Implementation Outcomes (and Why They Matter)30
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4 CFIR for Practitioners30
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5 EPIS & Phase-Based Thinking30
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6 Determinants vs Barriers vs Root Causes30
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7 Implementation Strategies That Actually Work30
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8 Engagement, Buy-In, and Trust30
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9 Adaptation vs Fidelity30
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10 Theory of Change & Logic Models for Practice30
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11 Implementation Evaluation & Learning30
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12 RE-AIM in Real Life30
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13 Common Implementation Failure Modes30
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14 Sustainment Is Not a Phase30
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15 Digital Health Implementation30
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16 Implementation × Human Factors30
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17 Scaling, Spread, and National Rollouts30
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18 Safety, Risk, and Escalation in Implementation30
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19 Leadership for Implementation30
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20 Implementation in High-Reliability Organisations (HROs)30
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21 Implementation Under Resource Constraints30
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22 Teaching & Coaching Implementation Science30
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23 Implementation Playbooks & Checklists (Done Right)30
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24 Diagnosing Stuck Implementations30
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ERIC — Strategy Selection & Misuse (Practitioner Diagnostic Deck)21
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Implementation Metrics — What Misleads, What Matters20
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Executive Mini Deck25
