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In view of this, the district directors of health and the NHIA must be actively involved from the early implementation stages for their support and goodwill in this regard.
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On the other hand, major differences often appear at the implementation stage for dose delivery.
These barriers should be addressed early in the implementation stage for guideline adoption to be successful.
We investigated mining mega-projects to analyze the effect of project complexity on (1) the "make vs. ally" choice for the implementation stage of a project and the "fixed-price vs. cost-plus" contractual choice when an "ally" was chosen; and (2) the extent to which prior interactions with a contractor at earlier stages of the same project impact the "fixed-price vs. cost-plus" decision.
The variations can be seen both in their basic definitions as well as recommendations for declaration thresholds, implementation stages, target population, and implementation logistics.
Change management comes into picture before implementation, during implementation and after implementation stages.
The implementation stages covered by the framework.
This resulted in a list of 18 factors for the adoption stage, 23 factors for the implementation stage, and 24 factors for the continuation stage; in total 37 different factors (see Table 1).
Most important factors that were included in the second round questionnaire (median ≥ 8 and mean ≥ 7.64 for the adoption stage; median ≥ 8 and mean ≥ 7.70 for the implementation stage; median ≥ 8 and mean ≥ 7.76 for the continuation stage) are shown in Table 1.
The questionnaire included the factors that were scored as most important by the experts in the first round (median ≥ 8 and mean ≥ 7.64 for the adoption stage; median ≥ 8 and mean ≥ 7.70 for the implementation stage; median ≥ 8 and mean ≥ 7.76 for the continuation stage).
Based on stages' grand mean scores of important factors, most important factors were factors with a median score of 8 or higher and a mean score of 7.64 or higher for the adoption stage, a mean score of 7.70 or higher for the implementation stage, and mean score of 7.76 or higher for the continuation stage.
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