{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:24:47Z","timestamp":1791390287267,"version":"4.3.3"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01 HS028000-01"],"award-info":[{"award-number":["R01 HS028000-01"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000867","name":"Robert Wood Johnson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000867","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Health Serv."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      The key\n                      <jats:italic>challenge<\/jats:italic>\n                      of successful implementation of healthcare innovations is balancing between intervention fidelity and the constantly changing healthcare environment where the implementation occurs. Unexpected changes as well as staff turnover are likely to affect implementation success and sustainability. Ensuring implementation fidelity requires researchers to adhere to the study design and implementation plan.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We augmented the Dynamic Adaptation Process model using strategies from quality improvement, clinical safety, and software development agility to allow for continuous adaptation of the implementation process to changes in community healthcare settings and to reduce the chance of implementation failure when implementing complex socio-technical solutions in fast-paced healthcare environments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\/discussion<\/jats:title>\n                    <jats:p>This project illustrates how this augmented model could avert \u201cimplementation failure\u201d based on real-life implementation cases of a socio-technical innovation to optimize cross-sector collaborations to support patients with medical, social and behavioral complexities. Key takeaways from the project highlight the importance of understanding baseline organizational readiness, designing for sustainability and spread, prioritizing engagement and communication, and ensuring a holistic design of socio-technical solutions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frhs.2026.1737047","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T06:51:52Z","timestamp":1772175112000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Balancing fidelity and flexibility: a case study presentation of an augmented dynamic adaptation process for socio-technical innovations in healthcare"],"prefix":"10.3389","volume":"6","author":[{"given":"Suzanne S.","family":"Sullivan","sequence":"first","affiliation":[{"name":"College of Nursing, Upstate Medical University, State University of New York","place":["Syracuse, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Hewner","sequence":"additional","affiliation":[{"name":"School of Nursing, University at Buffalo, State University of New York","place":["Buffalo, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Casucci","sequence":"additional","affiliation":[{"name":"Department of Industrial Systems Engineering, University at Buffalo, State University of New York","place":["Buffalo, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Bowen","sequence":"additional","affiliation":[{"name":"School of Social Work, University at Buffalo, State University of New York","place":["Buffalo, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Chandola","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Engineering, University at Buffalo, State University of New York","place":["Buffalo, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy M.","family":"Sheehan","sequence":"additional","affiliation":[{"name":"School of Nursing, University at Buffalo, State University of New York","place":["Buffalo, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Anderson","sequence":"additional","affiliation":[{"name":"School of Nursing, University at Buffalo, State University of New York","place":["Buffalo, NY, United States"]},{"name":"National Center on Homelessness Among Veterans, United States Department of Veterans Affairs","place":["Bronx, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarod","family":"Gabello","sequence":"additional","affiliation":[{"name":"School of Nursing, University at Buffalo, State University of New York","place":["Buffalo, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia","family":"Noyes","sequence":"additional","affiliation":[{"name":"Division of Health Services Policy and Practice, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo","place":["Buffalo, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1186\/s43058-020-00070-0","article-title":"Determinants of an evidence-based practice environment: an interpretive description","volume":"1","author":"Duff","year":"2020","journal-title":"Implement Sci Commun"},{"key":"B2","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1111\/wvn.12495","article-title":"Implementation science: application of evidence-based practice models to improve healthcare quality","volume":"18","author":"Tucker","year":"2021","journal-title":"Worldviews Evid Based Nurs"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s43058-021-00250-6","article-title":"Rates of sustainment in the universal stages of implementation completion","volume":"3","author":"Wong","year":"2022","journal-title":"Implement Sci Commun"},{"key":"B4","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/1748-5908-7-32","article-title":"Dynamic adaptation process to implement an evidence-based child maltreatment intervention","volume":"7","author":"Aarons","year":"2012","journal-title":"Implement Sci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1146\/annurev-publhealth-052220-112457","article-title":"Designing for dissemination and sustainability to promote equitable impacts on health","volume":"43","author":"Kwan","year":"2022","journal-title":"Annu Rev Public Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s12874-018-0610-y","article-title":"Periodic reflections: a method of guided discussions for documenting implementation phenomena","volume":"18","author":"Finley","year":"2018","journal-title":"BMC Med Res Methodol"},{"key":"B7","year":"2023"},{"key":"B8","year":"2019"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1489","DOI":"10.1111\/1475-6773.12415","article-title":"Trust and reflection in primary care practice redesign","volume":"51","author":"Lanham","year":"2016","journal-title":"Health Serv Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.1177\/10497323241302673","article-title":"Managing health without stable housing: dimensions of treatment burden and patient capacity for people with chronic health conditions experiencing homelessness","volume":"35","author":"Bowen","year":"2024","journal-title":"Qual Health Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/10547738251378678","article-title":"Evaluating treatment burden in patients with complex needs receiving a transition of care intervention: a rapid qualitative analysis","volume":"35","author":"Bowen","year":"2025","journal-title":"Clin Nurs Res"},{"key":"B12","year":"2024"},{"key":"B13","first-page":"109","article-title":"A population-based care transition model for chronically ill elders","volume":"32","author":"Hewner","year":"2014","journal-title":"Nurs Econ"},{"key":"B14","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.outlook.2014.03.003","article-title":"Aligning population-based care management with chronic disease complexity","volume":"62","author":"Hewner","year":"2014","journal-title":"Nurs Outlook"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2","DOI":"10.13063\/2327-9214.1282","article-title":"Integrating social determinants of health into primary care clinical and informational workflow during care transitions","volume":"5","author":"Hewner","year":"2017","journal-title":"eGEMS (Wash DC)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1111\/wvn.12286","article-title":"Reducing emergency room visits and in-hospitalizations by implementing best practice for transitional care using innovative technology and big data","volume":"15","author":"Hewner","year":"2018","journal-title":"Worldviews Evid Based Nurs"},{"key":"B17","doi-asserted-by":"publisher","first-page":"102044","DOI":"10.1016\/j.outlook.2023.102044","article-title":"A clinical classification framework for identifying persons with high social and medical needs: the COMPLEXedex-SDH","volume":"71","author":"Sullivan","year":"2023","journal-title":"Nurs Outlook"},{"key":"B18","year":""},{"key":"B19","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1111\/hsc.13567","article-title":"A qualitative study of effective collaboration among nurse home visitors, healthcare providers and community support services in the United States","volume":"30","author":"Williams","year":"2022","journal-title":"Health Soc Care Community"},{"key":"B20","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1111\/jep.13100","article-title":"The time has come: embedded implementation research for health care improvement","volume":"25","author":"Churruca","year":"2019","journal-title":"J Eval Clin Pract"},{"key":"B21","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1177\/1073110519857325","article-title":"Cross sector data sharing: necessity, challenge, and hope","volume":"47","author":"Schmit","year":"2019","journal-title":"J Law Med Ethics"},{"key":"B22","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1177\/0162243910377624","article-title":"This is not a boundary object: reflections on the origin of a concept","volume":"35","author":"Star","year":"2010","journal-title":"Sci Technol Human Values"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.1377\/hlthaff.2018.0704","article-title":"Interpersonal and organizational dynamics are key drivers of failure to rescue","volume":"37","author":"Smith","year":"2018","journal-title":"Health Aff (Millwood)"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1056\/NEJMsa0903048","article-title":"Variation in hospital mortality associated with inpatient surgery","volume":"361","author":"Ghaferi","year":"2009","journal-title":"N Engl J Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e47","DOI":"10.1002\/bjs.10031","article-title":"Importance of teamwork, communication and culture on failure-to-rescue in the elderly","volume":"103","author":"Ghaferi","year":"2016","journal-title":"Br J Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"894599","DOI":"10.3389\/frhs.2022.894599","article-title":"Building trusting relationships to support implementation: a proposed theoretical model","volume":"2","author":"Metz","year":"2022","journal-title":"Front Health Serv"},{"key":"B27","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1097\/PTS.0000000000000748","article-title":"The use of rapid response teams to reduce failure to rescue events: a systematic review","volume":"16","author":"Hall","year":"2020","journal-title":"J Patient Saf"},{"key":"B28","doi-asserted-by":"publisher","first-page":"3","DOI":"10.48558\/QNGV-KG05","article-title":"Equity is fundamental to implementation science","volume":"19","author":"Loper","year":"2021","journal-title":"Stanf Soc Innov Rev"},{"key":"B29","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1186\/1472-6963-14-281","article-title":"Rethinking the patient: using burden of treatment theory to understand the changing dynamics of illness","volume":"14","author":"May","year":"2014","journal-title":"BMC Health Serv Res"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1124054","DOI":"10.3389\/frhs.2023.1124054","article-title":"Expanding the evidence for cross-sector collaboration in implementation science: creating a collaborative, cross-sector, interagency, multidisciplinary team to serve patients experiencing homelessness and medical complexity at hospital discharge","volume":"3","author":"Anderson","year":"2023","journal-title":"Front Health Serv"},{"key":"B31","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1055\/a-2048-7343","article-title":"Identifying high-need primary care patients using nursing knowledge and machine learning methods","volume":"14","author":"Hewner","year":"2023","journal-title":"Appl Clin Inform"},{"key":"B32","first-page":"281","article-title":"Some methods for classification and analysis of multivariate observations","author":"MacQueen","year":"1967"},{"key":"B33","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s13012-023-01285-0","article-title":"The relative value of Pre-implementation stages for successful implementation of evidence-informed programs","volume":"18","author":"Alley","year":"2023","journal-title":"Implement Sci"},{"key":"B34","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1055\/s-0038-1637943","article-title":"Managing clinical knowledge for health care improvement","volume":"9","author":"Balas","year":"2000","journal-title":"Med Inform"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/13561820.2025.2502594","article-title":"Cross-sector collaboration in transitional care of people experiencing homelessness: insights from an exploratory network analysis","volume":"39","author":"Anderson","year":"2025","journal-title":"J Interprof Care"},{"key":"B36","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1177\/0162243910377624","article-title":"This is not a boundary-object. Reflections on the origin of the concept","volume":"4","author":"Star","year":"2010","journal-title":"Rev anthropol connaiss"}],"container-title":["Frontiers in Health Services"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frhs.2026.1737047\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T06:51:53Z","timestamp":1772175113000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frhs.2026.1737047\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":36,"alternative-id":["10.3389\/frhs.2026.1737047"],"URL":"https:\/\/doi.org\/10.3389\/frhs.2026.1737047","relation":{},"ISSN":["2813-0146"],"issn-type":[{"value":"2813-0146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]},"article-number":"1737047"}}