Purpose of the tool

This stage defines the intervention, maps how change will occur (including stakeholder actions), and identifies barriers and enablers to ensure the intervention is delivered as intended. The goal of this stage is to design an evidence-based intervention and plan its implementation.

How to use the tool

Work through the questions below, then create your own Project Plan and/or Program Logic. When you have completed the questions, you can print or save the tool to guide discussion with your colleagues or mentor.

Need more information?

If you’re unsure where to start or want to learn about this TRIP stage, click below to go to the relevant Learning Hub page.

Learn about Planning for Change
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WHAT: Define the Change

1. What do you intend to implement (or de-implement)?Consider the 7 Ps: Programs, Practices, Policies, Procedures, Principles, Pills, Products.

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Clearly outline what you plan to introduce, remove, or change in practice. Identify who is involved and what needs to be done differently.

Be specific about what will change in day-to-day practice, and who will carry it out. Avoid broad terms such as “implementing a guideline” or “introducing new technology.”

Consider each step, who is involved, and who needs to do what differently throughout the process.

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Breaking implementation into components creates clarity and supports structured planning from the outset. You can broadly consider this under the 7 Ps (from the Center for Implementation):

  • Programs: A set of coordinated activities to accomplish a specific goal (e.g., a pre-packaged evidence-based program)
  • Practices: The application of an idea or belief (e.g., guideline recommendations)
  • Policies: Legislative/regulatory decisions made to ensure that specific actions can be taken within a legal/regulatory framework (e.g., policies with regional policymakers and service providers to improve transitions in care)
  • Procedures: A set of instructions or sequential activities that help guide a specific action (e.g., a screening tool)
  • Principles: Beliefs/philosophies that guide action (e.g., using an equity-based approach to support underserved groups)
  • Pills: Refers broadly to any drugs that might be used to improve outcomes (e.g., a medication)
  • Products: Tools or resources that guide people in accomplishing activities/goals (e.g., an online learning platform or app).

2. What is the main aim of this project?What are you trying to improve or change?

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Define what you aim to achieve. A precise aim gives your project focus, supports alignment with strategic goals, and provides a clear basis for evaluation.

Ensure each aim can be measured – this will later be used to connect your outcomes and logic model.

Clearly state what the project aims to change or improve. A well-defined aim provides focus, aligns with strategic priorities, and forms the basis for evaluation. Each aim must be measurable and directly link to the project’s outcomes and logic model.

3. What are the intended outcomes and how will these be measured?List measurable outcomes and describe how success will be tracked (e.g. wait times, patient satisfaction, staff adherence).

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Determine your intended outcomes and the measures you’ll use to track change. One method is to compare the current state with the expected post-implementation state (e.g. wait-list reductions, shorter hospital stays, improved clinical outcomes).

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Implementation outcomes describe how well an intervention is delivered in practice. Fidelity is the extent to which an intervention is implemented as intended, in line with its planned design, content, and processes. Assessing fidelity shows whether results are due to the intervention, rather than variation in delivery.

Other implementation outcomes may include acceptability, feasibility, adoption, reach, sustainability, and cost, depending on the project context. Further guidance on selecting and measuring implementation outcomes is available in the linked resource.

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Effective outcomes are SMART: Specific, Measurable, Achievable, Relevant, and Time-bound. Avoid vague verbs. Instead of “improve efficiency”, define a clear comparison between the current and expected state (e.g. “reduce wait times by 20% within 6 months”). Specify the data source used to measure each outcome to ensure consistent tracking (e.g. daily discharge reports or weekly safety audits).

4. How does this project align with and enable strategic priorities?Align your project with existing organisational or statewide strategies to strengthen support.

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Ensure your project aligns with strategic priorities across all levels – this clarifies scope, strengthens collaboration, and increases sustainability.

Alignment builds credibility, increases stakeholder support, and can unlock funding opportunities. Consider broad to local plans and priorities, e.g.:

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Don’t underestimate the power of aligning your work with the priorities of others. Aligning your project to different strategies can help you leverage ‘buy-in’ and garner support. The advantage of aligning across all levels will allow you to:

  • Clarify project scope and direction
  • Identify aligned stakeholders and potential collaborators
  • Strengthen your case for support
  • ‘Speak the language’ of decision-makers
  • Increase visibility and sustainability of your project
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Check applicable strategic plans at department, profession, local/HHS, and system/state levels and capture how your project enables each one.

WHO: Identify the Stakeholders

5. Who needs to do something differently for this intervention to succeed?Identify all key stakeholders and note what matters most to them in relation to this project.

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Stakeholders are central to project success. Engaging the right people early helps anticipate barriers and sustain momentum.

Understanding their motivations and perspectives allows you to build effective engagement strategies and anticipate challenges.

Stakeholders include clinicians, administrators, support staff, patients, and external partners.

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Stakeholder relationships and perspectives strongly influence the success of a TRIP project. Focusing on a narrow group of stakeholders or using engagement approaches that do not suit all groups can limit impact. Assumptions about who will or will not engage may exclude key voices and increase resistance to change.

Revisit stakeholder mapping regularly — roles, influence, and engagement levels can shift as your project progresses.

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Use the TRIP Stakeholder Matrix and stakeholder mapping tools to decide who to engage and how much influence they have.

Open the TRIP Stakeholder Mapping Tool.

The WHO Stakeholder Mapping Guide provides greater detail and may help decide different engagement and communication strategies.

Open the WHO Stakeholder Mapping Guide.

6. What do your stakeholder groups need to do differently so change can occur?Specify behavioural or procedural changes needed, and by whom. Identify the behaviours that are most critical to achieving your outcome.

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Clarify which individuals or groups need to change their behaviours and what actions are required to make change possible.

For example, nurses may adopt a new assessment protocol, or managers may adjust rostering to support training.

This step translates your “what” (from question 1 above) into actionable steps for each group.

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Understanding which behaviours need to change, and the factors that make these changes easier or harder, is essential for designing effective individual-level implementation strategies.

7. What currently makes it difficult for people to perform this behaviour as intended?Think about the main behaviours you want to influence: WHO is involved, WHAT they need to do, and what the barriers are to these. Use COM-B to map barriers across the key components - Capability, Opportunity, Motivation.

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Categorising barriers clarifies where to focus your support, whether through training, system changes, or motivation strategies. When identifying potential barriers to change, consider questions such as:

  • What currently makes it difficult for people to perform this behaviour as intended?
  • What knowledge or skills might be missing?
  • What environmental or system factors get in the way (e.g. time, workload, tools, processes, systems)?
  • What social or cultural factors influence this behaviour (e.g. norms, leadership, expectations, team practices)?
  • What motivational or emotional factors affect this behaviour (e.g. beliefs, confidence, habits, emotions)?
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To ensure the WHAT (actions) you list here are realistic, apply the COM-B model. For each stakeholder group, ask:

  • Capability: Can they do it? (Skills & Knowledge)
  • Opportunity: Is it possible to do it? (Time, Staffing & Resources)
  • Motivation: Will they do it? (Beliefs & Habits)

If any of these three drivers are missing, the behaviour change is unlikely to stick.

You can use the Theoretical Domains Framework (TDF) alongside COM-B for deeper analysis. The COM-B model and the Theoretical Domains Framework (TDF) can help identify what drives behaviour and guide decisions about who needs to do what and how best to support them. These frameworks can be used individually or together to provide a clear, structured approach to influencing behaviour.

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Watch the short COM-B introduction video for a practical overview before mapping barriers.

Open the COM-B introduction video.

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Social Change UK provides information regarding the COM-B: A Guide on the COM-B Model of Behaviour.

Opportunity factors to consider when identifying barriers to behaviour change

WHERE: Consider the Setting

8. What contextual considerations are important?Consider the broader environment in which implementation will occur – from the specific team to the wider health system.

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Your project’s success depends on its context — the environment, systems, and structures in which it operates. A strong understanding of context helps identify enablers and barriers early.

Once you understand what and who will change, examine the environment that will support or hinder that change.

The four domains below are drawn from i-PARIHS and CFIR. They are deliberately simplified for planning purposes to allow the user to think practically about where the project is happening and what contextual factors may influence success.

  • The proposed innovation: The specific intervention or “thing” being implemented.
  • Inner setting: The immediate context — team, department, or organisation.
  • Outer setting: Broader environment — hospital network, state, or system.
  • Implementation process: Activities and strategies supporting rollout and adoption.
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Your context is where and how you plan to make a change, including everything unique about your environment or setting. Determinant frameworks are used to identify what helps (enablers) and hinders (barriers) change in your context.

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The Center for Implementation and i-PARIHS have both developed context assessment tools.

Read more about a context assessment and access the Center for Implementation Context Compass Framework here: Context Compass Framework.

The mi-PARIHS facilitation planning tool can be downloaded here: mi-PARIHS facilitation planning tool.

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Read the TRIP Introduction to Theories, Models and Frameworks document to understand more about frameworks relevant to your project.

Open the QH-TRIP Introduction to Theories, Models, and Frameworks PDF.

Considerations about the "thing" being implemented.
Your team, department, hospital.
Hospital system, state, external factors.
The activities needed to implement the change.

Output: Project Plan

A project plan provides a structured roadmap to guide implementation and support successful, sustainable change. The plan should clearly outline the objectives, planned activities, timeline, required resources, risks and outcomes being measured.

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Use the TRIP Project Plan on a Page template to summarise and communicate your project plan visually.

Open the TRIP Plan on a Page template.

Output: Program Logic Model

Program logic models show the pathway from project initiation to impact. A program logic shows how your project’s activities lead to outputs, outcomes, and long-term impact. It clarifies the causal link between what you do and what you aim to achieve.

A program logic is more than a diagram—it is a way to:

  • Define what the project is trying to achieve and how success will be measured.
  • Provide a roadmap for activities, making it easier to stay focused and on track.
  • Communicate your project’s approach and value clearly to funders, partners, and end-users.
  • Demonstrate outcomes and impact, strengthening accountability and future funding opportunities.

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Unsure whether to use a Project Plan, Program Logic Model, or Implementation Plan? Use the TRIP comparison guide to choose the most appropriate planning tool for your project.

What TRIP Plan Do I Need?

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Use the TRIP Program Logic Model template to create your project logic model.

Open the Program Logic Model tool.

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Midlands and Lancashire CSU Strategy Unit. (2016). Your guide to using logic models. Midlands & Lancashire Commissioning Support Unit.