RT Journal Article SR Electronic T1 Ingredients for change: revisiting a conceptual framework JF Quality and Safety in Health Care JO Qual Saf Health Care FD BMJ Publishing Group Ltd SP 174 OP 180 DO 10.1136/qhc.11.2.174 VO 11 IS 2 A1 J Rycroft-Malone A1 A Kitson A1 G Harvey A1 B McCormack A1 K Seers A1 A Titchen A1 C Estabrooks YR 2002 UL http://qualitysafety.bmj.com/content/11/2/174.abstract AB Finding ways to deliver care based on the best possible evidence remains an ongoing challenge. Further theoretical developments of a conceptual framework are presented which influence the uptake of evidence into practice. A concept analysis has been conducted on the key elements of the framework—evidence, context, and facilitation—leading to refinement of the framework. While these three essential elements remain key to the process of implementation, changes have been made to their constituent sub-elements, enabling the detail of the framework to be revised. The concept analysis has shown that the relationship between the elements and sub-elements and their relative importance need to be better understood when implementing evidence based practice. Increased understanding of these relationships would help staff to plan more effective change strategies. Anecdotal reports suggest that the framework has a good level of validity. It is planned to develop it into a practical tool to aid those involved in planning, implementing, and evaluating the impact of changes in health care.