Choosing the Models Before the Rollout

In practice

A hospital is about to roll out a sepsis bundle. Two model choices are made first, because selecting them afterwards means the plan was built without them. A process model describes how evidence moves into practice — the Stetler model and Knowledge-to-Action are both process models, and both describe a sequence a clinician follows. An organizational model describes how a system changes, which is a different question with different mechanisms. Both are selected, because a process model with no organizational model produces a well-sequenced plan nobody adopts. Fit is the deciding criterion rather than merit: the models share a skeleton, so the question is which one matches this setting rather than which is best in the abstract. The ARCC model is chosen here because its mechanism is mentors, and this organisation already has a mentor cadre. A determinant framework is added on top — CFIR names the domains that will decide whether the bundle sticks, and RE-AIM is chosen as the evaluation framework because the question is about reach and maintenance rather than only effect. Naming the evaluation framework before the rollout also fixes what will count as success, which is far harder to agree once results are arriving and everyone has an interest in the definition.