Phase 3: Implementation

Execute the plan using evidence-based implementation strategies, training, management engagement, and staged rollout.

Bottom Line Successful hospital acupuncture implementation requires coordinating both internal factors (organisational structure, communication, readiness) and external factors (patient needs, peer networks, policy). Use proven implementation strategies — opinion leaders are the most effective at 12% behaviour change — and start with a controlled pilot before scaling.

To ensure that acupuncture/acupressure is implemented, both inner enablers and outside enablers are needed. Inner factors have five main domains, such as organisation characteristics, network and communication, climate for change and readiness for change; and outer factors have four domains, such as patient needs, peer pressure, network of the organisation and external policy.

Structure

Structure of the Organisation

References CFIR's "Structural Characteristics," discussing how implementation scope determines departmental involvement.

"If acupressure is used for 24 hours peri-surgically, then staff from admission, theatre, recovery to the wards will be involved."

"Coordination and communication among those units are essential" — ensure "all key stakeholders are part of the team."

Priority and Goals

Aligning Priorities

Addresses clinician priorities alignment with implementation, described as "a stronger predictor of the effectiveness of implementation."

Advocates communicating goals and providing feedback aligned with staff objectives.

Implementation Strategies

Grimshaw's 2012 Review Findings

Strategy effectiveness:

Strategy Effectiveness Acupressure Example
Printed educational material 4.3% Evidence summary handouts, point location guides, patient information sheets
Educational meetings 6% Grand rounds presentations, ward in-service sessions, lunchtime seminars
Local opinion leaders 12% High Respected senior clinicians who advocate for acupuncture/acupressure and mentor colleagues
Audit and feedback 5% Regular reports on intervention uptake, patient outcomes, and compliance

Training

Access to Knowledge and Information (CFIR)

Describes three training packages differentiated by professional roles, plus on-the-job training protocols.

Engaging Management

Leadership Engagement (CFIR)

Addresses "Leadership Engagement under CFIR," defined as "commitment, involvement, and accountability of leaders and managers."

Discusses support mechanisms across executive, middle, and frontline levels.

Assess

Reflecting and Evaluating (CFIR)

Related to "Reflecting and evaluating under CFIR." Emphasizes defining outcome measures, tracking systems, and regular staff feedback through audits.

Execute the Implementation

Adoption Strategies

Recommends adoption strategies: practice runs, pilot implementations, and step-approach implementation limiting scope initially.

Phase 3 Resources

Last reviewed: April 2026