{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:41:33Z","timestamp":1792489293371,"version":"4.5.0"},"reference-count":84,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Qual Saf"],"accepted":{"date-parts":[[2026,5,4]]},"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1136\/bmjqs-2025-019148","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:20:35Z","timestamp":1780593635000},"page":"768-777","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Building capacity for change: developing an evidence-based competencies framework to power champions"],"prefix":"10.1136","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1878-3464","authenticated-orcid":false,"given":"Harveer","family":"Punia","sequence":"first","affiliation":[{"name":"Registered Nurses Association of Ontario, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Zucal","sequence":"additional","affiliation":[{"name":"Registered Nurses Association of Ontario, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Julian","sequence":"additional","affiliation":[{"name":"Registered Nurses Association of Ontario, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Wallace","sequence":"additional","affiliation":[{"name":"Registered Nurses Association of Ontario, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"McNeill","sequence":"additional","affiliation":[{"name":"Registered Nurses Association of Ontario, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Grinspun","sequence":"additional","affiliation":[{"name":"Registered Nurses Association of Ontario, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"2026102002101799000_35.11.768.1","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2006.022046"},{"key":"2026102002101799000_35.11.768.2","unstructured":"Health Quality Ontario . Quality improvement guide. HQO; 2012. Available: https:\/\/www.hqontario.ca\/portals\/0\/documents\/qi\/qi-quality-improve-guide-2012-en.pdf"},{"key":"2026102002101799000_35.11.768.3","unstructured":"World Health Organization . WHO launches new guide to help boost quality in health services. WHO; 2025. Available: https:\/\/www.who.int\/news\/item\/16-04-2025-who-launches-new-guide-to-help-boost-quality-in-health-services"},{"key":"2026102002101799000_35.11.768.4","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s13012-022-01201-y","article-title":"Revisiting concepts of evidence in implementation science","volume":"17","author":"Brownson","year":"2022","journal-title":"Implement Sci"},{"key":"2026102002101799000_35.11.768.5","doi-asserted-by":"crossref","unstructured":"Jolliffe L , Lannin NA , Larcombe S , et al . Training and education provided to local change champions within implementation trials: a rapid systematic review. Implement Sci 2025. doi:10.1186\/s13012-025-01416-9","DOI":"10.1186\/s13012-025-01416-9"},{"key":"2026102002101799000_35.11.768.6","doi-asserted-by":"crossref","DOI":"10.3389\/frhs.2021.817750","article-title":"Bridging the Silos: A Comparative Analysis of Implementation Science and Improvement Science","volume":"1","author":"Nilsen","year":"2021","journal-title":"Front Health Serv"},{"key":"2026102002101799000_35.11.768.7","unstructured":"Grinspun D , Bajnok I . Transforming Nursing Through Knowledge: Best Practices in Guideline Development Implementation Science and Evaluation. Indianapolis, IN: Sigma Theta Tau International, 2018."},{"key":"2026102002101799000_35.11.768.8","doi-asserted-by":"crossref","DOI":"10.1186\/s43058-022-00315-0","article-title":"The effectiveness of champions in implementing innovations in health care: a systematic review","volume":"3","author":"Santos","year":"2022","journal-title":"Implement Sci Commun"},{"key":"2026102002101799000_35.11.768.9","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12911-016-0240-4","article-title":"What is the extent of research on the characteristics, behaviors, and impacts of health information technology champions? A scoping review","volume":"16","author":"Shea","year":"2015","journal-title":"BMC Med Inform Decis Mak"},{"key":"2026102002101799000_35.11.768.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-024-10867-7","article-title":"The role of champions in the implementation of technology in healthcare services: a systematic mixed studies review","volume":"24","author":"Pettersen","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"2026102002101799000_35.11.768.11","doi-asserted-by":"crossref","first-page":"2050312118773261","DOI":"10.1177\/2050312118773261","article-title":"Inside help: An integrative review of champions in healthcare-related implementation","volume":"6","author":"Miech","year":"2018","journal-title":"SAGE Open Med"},{"key":"2026102002101799000_35.11.768.12","doi-asserted-by":"publisher","DOI":"10.1111\/wvn.12262"},{"key":"2026102002101799000_35.11.768.13","doi-asserted-by":"crossref","DOI":"10.1002\/gin2.70052","article-title":"Best Practice Guideline Development Methods: An Integrated Approach Based on the Registered Nurses\u2019 Association of Ontario\u2019s Methods","volume":"3","author":"Howitt","year":"2026","journal-title":"Clinical and Public Health Guidelines"},{"key":"2026102002101799000_35.11.768.14","doi-asserted-by":"publisher","DOI":"10.1002\/chp.47"},{"key":"2026102002101799000_35.11.768.15","first-page":"15","article-title":"Leading change through social movement","volume":"32","author":"Grinspun","year":"2020","journal-title":"RNJ"},{"key":"2026102002101799000_35.11.768.16","first-page":"411","article-title":"Exploring social movement concepts and actions in a knowledge uptake and sustainability context: A concept analysis","volume":"9","author":"Grinspun","year":"2022","journal-title":"Int J Nurs Sci"},{"key":"2026102002101799000_35.11.768.17","unstructured":"Metz A , Burke K , Albers B , et al . A Practice Guide to Supporting Implementation - What competencies do we need. 2020. doi:10.13140\/RG.2.2.27777.28006"},{"key":"2026102002101799000_35.11.768.18","unstructured":"Registered Nurses\u2019 Association of Ontario (RNAO) . RNAO. 2026. Available: https:\/\/rnao.ca\/bpg\/champions"},{"key":"2026102002101799000_35.11.768.19","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1002\/cbe2.1011","article-title":"The operational definition of competency\u2010based education","volume":"1","author":"Gervais","year":"2016","journal-title":"J of Competency-Based Ed"},{"key":"2026102002101799000_35.11.768.20","unstructured":"Registered Nurses\u2019 Association of Ontario (RNAO), Healthcare Excellence Canada (HEC) . Leading change toolkit. Toronto, ON RNAO; 2021. Available: https:\/\/www.RNAO.ca\/leading-change-toolkit"},{"key":"2026102002101799000_35.11.768.21","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"2026102002101799000_35.11.768.22","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-69"},{"key":"2026102002101799000_35.11.768.23","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3928\/00989134-20210706-01","article-title":"Using Appreciative Inquiry to Optimize a Person-Centered Care Training Program for Clinical Champions in Rural Critical Access Hospitals","volume":"47","author":"Buck","year":"2021","journal-title":"J Gerontol Nurs"},{"key":"2026102002101799000_35.11.768.24","doi-asserted-by":"crossref","first-page":"26334895221077880","DOI":"10.1177\/26334895221077880","article-title":"Examining health care champions: a mixed-methods study exploring self and peer perspectives of champions","volume":"3","author":"George","year":"2022","journal-title":"Implement Res Pract"},{"key":"2026102002101799000_35.11.768.25","unstructured":"Branagan L . An exploratory investigation of physician champions for hospital-based information technology implementations [a dissertation presented to the faculty of the marshall goldsmith school of management san francisco bay campus alliant international university in partial fulfillment of the requirements of the degree doctor of philosophy]. Marshall Goldsmith School of Management San Francisco Bay Campus Alliant International University; 2010."},{"key":"2026102002101799000_35.11.768.26","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0248677","article-title":"Understanding how and why audits work in improving the quality of hospital care: A systematic realist review","volume":"16","author":"Hut-Mossel","year":"2021","journal-title":"PLoS ONE"},{"key":"2026102002101799000_35.11.768.27","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.acap.2019.01.006","article-title":"A Qualitative Study Examining Stakeholder Perspectives of a Local Child Abuse Program in Community Emergency Departments","volume":"19","author":"Tiyyagura","year":"2019","journal-title":"Acad Pediatr"},{"key":"2026102002101799000_35.11.768.28","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.nedt.2017.12.026","article-title":"Turning education into action: Impact of a collective social education approach to improve nurses\u2019 ability to recognize and accurately assess delirium in hospitalized older patients","volume":"62","author":"Travers","year":"2018","journal-title":"Nurse Educ Today"},{"key":"2026102002101799000_35.11.768.29","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1111\/ijn.12106","article-title":"Developing evidence\u2010based practice champions in the M aldives","volume":"19","author":"Shifaza","year":"2013","journal-title":"Int J Nurs Pract"},{"key":"2026102002101799000_35.11.768.30","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/NNA.0000000000000578","article-title":"Development of an RN Champion Model to Improve the Outcomes of Ventilator-Associated Pneumonia Patients in the Intensive Care Unit","volume":"48","author":"Robinson","year":"2018","journal-title":"JONA"},{"key":"2026102002101799000_35.11.768.31","unstructured":"Luton A , Gordon M , Stewart M , et al . Evidence-based skin champion program reduces pressure injuries in a pediatric hospital. J Nurs Interprofessional Leadersh Qual Saf 2018;2."},{"key":"2026102002101799000_35.11.768.32","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.sapharm.2017.04.007","article-title":"Forming and activating an internal facilitation group for successful implementation: A qualitative study","volume":"13","author":"McCullough","year":"2017","journal-title":"Research in Social and Administrative Pharmacy"},{"key":"2026102002101799000_35.11.768.33","doi-asserted-by":"crossref","DOI":"10.1186\/s13012-015-0289-y","article-title":"Successful implementation of an enhanced recovery after surgery programme for elective colorectal surgery: a process evaluation of champions\u2019 experiences","volume":"10","author":"Gotlib Conn","year":"2015","journal-title":"Implement Sci"},{"key":"2026102002101799000_35.11.768.34","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.pmn.2014.04.002","article-title":"Positioning clinical nurse specialists and nurse practitioners as change champions to implement a pain protocol in long-term care","volume":"16","author":"Kaasalainen","year":"2015","journal-title":"Pain Manag Nurs"},{"key":"2026102002101799000_35.11.768.35","first-page":"13","article-title":"Developing champions to enhance the care of people with dementia in general hospitals","volume":"106","author":"Crabtree","year":"2010","journal-title":"Nurs Times"},{"key":"2026102002101799000_35.11.768.36","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2021.02.200311"},{"key":"2026102002101799000_35.11.768.37","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/j.1741-6787.2010.00202.x","article-title":"The role of nursing best practice champions in diffusing practice guidelines: a mixed methods study","volume":"7","author":"Ploeg","year":"2010","journal-title":"Worldviews Evid Based Nurs"},{"key":"2026102002101799000_35.11.768.38","first-page":"31","article-title":"Implementation of an electronic medical record in family practice: a case study","volume":"18","author":"Gagnon","year":"2010","journal-title":"J Innov Health Inform"},{"key":"2026102002101799000_35.11.768.39","doi-asserted-by":"crossref","unstructured":"Lam JY , Howlett A , McLuckie D , et al . Developing implementation strategies to adopt Enhanced Recovery After Surgery (ERAS\u00ae) guidelines. BJS Open 2021;zraa011. doi:10.1093\/bjsopen\/zraa011","DOI":"10.1093\/bjsopen\/zraa011"},{"key":"2026102002101799000_35.11.768.40","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1111\/jnu.12131","article-title":"Methods of Genomic Competency Integration in Practice","volume":"47","author":"Jenkins","year":"2015","journal-title":"J Nurs Scholarsh"},{"key":"2026102002101799000_35.11.768.41","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1136\/bmjnph-2021-000281","article-title":"The role of trained champions in sustaining and spreading nutrition care improvements in hospital: qualitative interviews following an implementation study","volume":"4","author":"Laur","year":"2021","journal-title":"BMJ Nutr Prev Health"},{"key":"2026102002101799000_35.11.768.42","doi-asserted-by":"crossref","first-page":"676","DOI":"10.3122\/jabfm.2012.05.110281","article-title":"The Role of the Champion in Primary Care Change Efforts: From the State Networks of Colorado Ambulatory Practices and Partners (SNOCAP)","volume":"25","author":"Shaw","year":"2012","journal-title":"The Journal of the American Board of Family Medicine"},{"key":"2026102002101799000_35.11.768.43","doi-asserted-by":"crossref","first-page":"100516","DOI":"10.1016\/j.hjdsi.2020.100516","article-title":"Spreading the Veterans Health Administration\u2019s emergency department rapid access clinics (ED-RAC) innovation: Role of champions and local contexts","volume":"9","author":"Penney","year":"2021","journal-title":"Healthcare (Basel)"},{"key":"2026102002101799000_35.11.768.44","unstructured":"Feagan T . Exploring emergent, grassroots change: the critical role of grassroot change agents [a dissertation submitted to the faculty of the school of professional studies of gonzaga university in partial fulfillment of the requirements for the degree of doctor of philosophy]. School of Professional Studies of Gonzaga University; 2012."},{"key":"2026102002101799000_35.11.768.45","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/01.NUMA.0000853152.64293.46","article-title":"EBP champion responsibilities and sustainability","volume":"53","author":"Ferren","year":"2022","journal-title":"Nurs Manag (Harrow)"},{"key":"2026102002101799000_35.11.768.46","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/wvn.12436","article-title":"Evaluating the Implementation of a Multi-Component Intervention to Prevent Surgical Site Infection and Promote Evidence-Based Practice","volume":"17","author":"Lin","year":"2020","journal-title":"Worldviews Evid Based Nurs"},{"key":"2026102002101799000_35.11.768.47","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2012.12.001"},{"key":"2026102002101799000_35.11.768.48","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6963-13-123","article-title":"\u201cOne of those areas that people avoid\u201d a qualitative study of implementation in miscarriage management","volume":"13","author":"Darney","year":"2013","journal-title":"BMC Health Serv Res"},{"key":"2026102002101799000_35.11.768.49","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-022-01619-1"},{"key":"2026102002101799000_35.11.768.50","unstructured":"DuBose-Morris R . An interpretative phenomenological analysis of telehealth champions [a dissertation submitted in partial fulfillment of the requirements for the degree of doctor of philosophy in computing technology in education graduate school of computer and information sciences nova southeastern university]. Graduate School of Computer and Information Sciences Nova Southeastern University; 2013."},{"key":"2026102002101799000_35.11.768.51","doi-asserted-by":"crossref","DOI":"10.3389\/frhs.2022.920830","article-title":"Strategies for the implementation of a nasal decolonization intervention to prevent surgical site infections within the Veterans Health Administration","volume":"2","author":"Hockett Sherlock","year":"2022","journal-title":"Front Health Serv"},{"key":"2026102002101799000_35.11.768.52","doi-asserted-by":"crossref","unstructured":"Hadjistavropoulos T , Williams J , Kaasalainen S , et al . Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation. Pain Res Manag 2016. doi:10.1155\/2016\/6493463","DOI":"10.1155\/2016\/6493463"},{"key":"2026102002101799000_35.11.768.53","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1002\/aorn.12123","article-title":"Implementation of a Wisconsin Division of Public Health Surgical Site Infection Prevention Champion Initiative","volume":"107","author":"Borlaug","year":"2018","journal-title":"AORN J"},{"key":"2026102002101799000_35.11.768.54","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.mnl.2015.11.007","article-title":"Igniting Change Through an Empowered Frontline: A Unique Improvement Approach Centered on Staff Engagement, Empowerment, and Professional Development","volume":"14","author":"Scanlon","year":"2016","journal-title":"Nurse Lead"},{"key":"2026102002101799000_35.11.768.55","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1513\/AnnalsATS.201810-735OC","article-title":"Implementation of an Academic-to-Community Hospital Intensive Care Unit Quality Improvement Program. Qualitative Analysis of Multilevel Facilitators and Barriers","volume":"16","author":"Johnson","year":"2019","journal-title":"Ann Am Thorac Soc"},{"key":"2026102002101799000_35.11.768.56","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1177\/0308022615586785","article-title":"Occupational therapists as change agents in multidisciplinary teams","volume":"78","author":"Brian","year":"2015","journal-title":"British Journal of Occupational Therapy"},{"key":"2026102002101799000_35.11.768.57","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1111\/j.1365-2753.2010.01518.x","article-title":"Roles of managers, frontline staff and local champions, in implementing quality improvement: stakeholders\u2019 perspectives","volume":"18","author":"Kirchner","year":"2012","journal-title":"J Eval Clin Pract"},{"key":"2026102002101799000_35.11.768.58","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1093\/jamiaopen\/ooz051","article-title":"Physician champions\u2019 perspectives and practices on electronic health records implementation: challenges and strategies","volume":"3","author":"Gui","year":"2020","journal-title":"JAMIA Open"},{"key":"2026102002101799000_35.11.768.59","doi-asserted-by":"crossref","DOI":"10.1177\/2050312118792426","article-title":"A qualitative study of clinical champions in context: Clinical champions across three levels of acute care","volume":"6","author":"Flanagan","year":"2018","journal-title":"SAGE Open Med"},{"key":"2026102002101799000_35.11.768.60","first-page":"638","article-title":"Primary health care teams\u2019 experience of electronic medical record use after adoption","volume":"43","author":"Denomme","year":"2011","journal-title":"Fam Med"},{"key":"2026102002101799000_35.11.768.61","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12909-016-0597-1","article-title":"Educating change agents: a qualitative descriptive study of graduates of a Master\u2019s program in evidence-based practice","volume":"16","author":"Hole","year":"2016","journal-title":"BMC Med Educ"},{"key":"2026102002101799000_35.11.768.62","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1186\/s13012-020-01024-9","article-title":"Champions in context: which attributes matter for change efforts in healthcare","volume":"15","author":"Bonawitz","year":"2020","journal-title":"Implement Sci"},{"key":"2026102002101799000_35.11.768.63","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/jan.13838","article-title":"Characteristics and behaviours of formal versus informal nurse champions and their relationship to innovation success","volume":"75","author":"Luz","year":"2019","journal-title":"J Adv Nurs"},{"key":"2026102002101799000_35.11.768.64","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.outlook.2019.02.001","article-title":"Nursing innovation: The joint effects of championship behaviors, project types, and initiation levels","volume":"67","author":"Luz","year":"2019","journal-title":"Nurs Outlook"},{"key":"2026102002101799000_35.11.768.65","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-020-05227-0","article-title":"Moving enhanced recovery after surgery from implementation to sustainability across a health system: a qualitative assessment of leadership perspectives","volume":"20","author":"Gramlich","year":"2020","journal-title":"BMC Health Serv Res"},{"key":"2026102002101799000_35.11.768.66","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2011.02.009"},{"key":"2026102002101799000_35.11.768.67","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2020.0856"},{"key":"2026102002101799000_35.11.768.68","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1111\/jonm.13514","article-title":"The role of champions in leading domestic violence and abuse practice improvement in health care: A scoping review","volume":"30","author":"Saberi","year":"2022","journal-title":"J Nurs Manag"},{"key":"2026102002101799000_35.11.768.69","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1177\/2057158521995994","article-title":"Change agents\u2019 experiences of implementing a new organizational culture in residential care for older people: A qualitative study","volume":"41","author":"Ericson-Lidman","year":"2021","journal-title":"Nord J Nurs Res"},{"key":"2026102002101799000_35.11.768.70","unstructured":"Fabro M . Stroke management: dysphagia screening program [a doctor of nursing practice project submitted to the office of graduate education of the university of hawai\u2019i at manoa in partial fulfillment of the requirement for the degree of doctor of nursing practice]. University of Hawai\u2019i at Manoa; 2016."},{"key":"2026102002101799000_35.11.768.71","doi-asserted-by":"crossref","unstructured":"Siebeck OS , Hoving C . Characteristics of a Successful Nurse Peer Champion in the Implementation of Digital Technologies in Hospitals: A Qualitative Study. SSRN 2024. doi:10.2139\/ssrn.4796789","DOI":"10.2139\/ssrn.4796789"},{"key":"2026102002101799000_35.11.768.72","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/NNA.0000000000000856","article-title":"Evidence-Based Practice Change Champion Program Improves Quality Care","volume":"50","author":"Cullen","year":"2020","journal-title":"JONA"},{"key":"2026102002101799000_35.11.768.73","doi-asserted-by":"crossref","DOI":"10.1186\/s13012-019-0943-x","article-title":"\u201cThe role as a champion is to not only monitor but to speak out and to educate\u201d: the contradictory roles of hand hygiene champions","volume":"14","author":"Goedken","year":"2019","journal-title":"Implement Sci"},{"key":"2026102002101799000_35.11.768.74","doi-asserted-by":"crossref","DOI":"10.1186\/s13006-015-0030-0","article-title":"The bumpy road to implementing the Baby-Friendly Hospital Initiative in Austria: a qualitative study","volume":"10","author":"Wieczorek","year":"2015","journal-title":"Int Breastfeed J"},{"key":"2026102002101799000_35.11.768.75","doi-asserted-by":"crossref","unstructured":"Msunyaro E , Rangi J , Haonga T , et al . Contribution of community champions to accelerate the uptake of COVID-19 vaccination in Rukwa region, Tanzania, February - October 2022. Pan Afr Med J 2023;45. doi:10.11604\/pamj.supp.2023.45.1.39705","DOI":"10.11604\/pamj.supp.2023.45.1.39705"},{"key":"2026102002101799000_35.11.768.76","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1177\/0008417421994367","article-title":"Acting as Change Agents: Insight Into Qu\u00e9bec Occupational Therapists\u2019 Current Practice: Actions men\u00e9es \u00e0 titre d\u2019agents de changement\u202f: aper\u00e7u des pratiques actuelles parmi les ergoth\u00e9rapeutes du Qu\u00e9bec","volume":"88","author":"Carrier","year":"2021","journal-title":"Can J Occup Ther"},{"key":"2026102002101799000_35.11.768.77","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s13012-020-01048-1","article-title":"Lessons learned about the effective operationalization of champions as an implementation strategy: results from a qualitative process evaluation of a pragmatic trial","volume":"15","author":"Bunce","year":"2020","journal-title":"Implementation Sci"},{"key":"2026102002101799000_35.11.768.78","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2022-008907","article-title":"The role of emergent champions in policy implementation for decentralised drug-resistant tuberculosis care in South Africa","volume":"7","author":"Le Roux","year":"2022","journal-title":"BMJ Glob Health"},{"key":"2026102002101799000_35.11.768.79","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1177\/00084174211022891","article-title":"Occupational Therapists as Social Change Agents: Exploring Factors that Influence Their Actions","volume":"88","author":"Picotin","year":"2021","journal-title":"Can J Occup Ther"},{"key":"2026102002101799000_35.11.768.80","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-019-4309-5","article-title":"Barriers and facilitators to implementing a pragmatic trial to improve advance care planning in the nursing home setting","volume":"19","author":"Palmer","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"2026102002101799000_35.11.768.81","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-018-3099-5","article-title":"Informing implementation of quality improvement in Australian primary care","volume":"18","author":"Hespe","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"2026102002101799000_35.11.768.82","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1080\/08982112.2015.968042","article-title":"An Emerging Science of Improvement in Health Care","volume":"27","author":"Bergman","year":"2015","journal-title":"Qual Eng"},{"key":"2026102002101799000_35.11.768.83","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-9"},{"key":"2026102002101799000_35.11.768.84","doi-asserted-by":"crossref","unstructured":"Benner P . From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo-Park: Addison-Wesley, 1984:13\u201334","DOI":"10.1097\/00000446-198412000-00025"}],"container-title":["BMJ Quality & Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjqs-2025-019148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:10:53Z","timestamp":1792487453000},"score":1,"resource":{"primary":{"URL":"https:\/\/qualitysafety.bmj.com\/lookup\/doi\/10.1136\/bmjqs-2025-019148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":84,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,10,20]]},"published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1136\/bmjqs-2025-019148"],"URL":"https:\/\/doi.org\/10.1136\/bmjqs-2025-019148","relation":{},"ISSN":["2044-5415","2044-5423"],"issn-type":[{"value":"2044-5415","type":"print"},{"value":"2044-5423","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]}}}