Support

It can be really tempting to jump straight into implementing a new idea – especially if you’ve seen something that looks promising. It’s also common in TRIP projects to move to solutions before fully understanding the clinical problem. This can lead to trying to fit a problem to a solution, rather than the other way around. Working through the TRIP stages helps you make sure you’re addressing the right problem and designing something that will actually work in your context.

Sometimes, we need to slow down to speed up. The planning stage is where you build a clear understanding of the context you’re working in – including what might help or get in the way of your change. Without this, it’s much harder to choose the right strategies to support implementation. Planning helps set you up so your change is not just evidence-based, but also practical and achievable in your setting.

This happens more often than you might think. You might realise the problem isn’t what you thought it was, or that it’s not a priority for others. It’s completely okay to pause or stop at this point. TRIP is about focusing effort where it matters most – for patients, staff, and the health system. Redirecting your time to a more meaningful problem is a good outcome, not a failure. If you’re supporting someone else, this can be a tricky conversation – but helping them focus on high-impact problems is part of the process.

TRIP projects are grounded in strong evidence for change. If there isn’t clear evidence, it might mean you’re asking a question that hasn’t been fully answered yet, or that your work sits more in innovation rather than implementation. Other forms of evidence – like clinical expertise, local data, and stakeholder perspectives – can still be useful. The key is being clear about what kind of work you’re doing and what evidence is guiding it.

At the Planning for Change stage, the goal is to really understand your context and what needs to change. This means identifying who needs to do what differently, and what might help or get in the way.

Frameworks can support this. For example, CFIR can help you explore your context, whereas COM-B and TDF can help you understand behaviour.

You don’t need to apply these perfectly – they’re there to guide your thinking and help you look beyond education or training as the only solution.

Here are some important papers and videos for COM-B and TDF:

The Behaviour Change Wheel paper (introduces COM-B and the Behaviour Change Wheel)

Choosing Wisely’s excellent summary of designing interventions that integrate behaviour change (similar to the steps described below)

A guide to using the Theoretical Domains Framework to investigate implementation problems

More about TDF from the Canadian Health Institute KT platform

Different people engage in different ways. Some stakeholders will respond well to meetings and emails, while others won’t. You might need to think more creatively – quick conversations, visual summaries, or informal engagement can often be more effective. There’s no single approach that works for everyone. Being flexible and trying different strategies is usually key.

A big part of planning is understanding what might help or get in the way of change. You can explore this through conversations with your team, interviews or discussions, and surveys or observations. As you go, your understanding will evolve – and that’s expected. Identifying what’s already working can be just as useful as identifying barriers.