EPIS has four well-defined phases that align with the implementation process, identification of outer system and inner organizational contexts, and “bridging and innovation factors” that have to do with the innovation/EBP being implemented and the interplay of outer and inner context. The four phases are:
In the Exploration phase, a service system, organization, research group, or other stakeholder(s) consider the emergent or existing health needs of the patients, clients, or communities and work to identify the best EBP(s) to address those needs, and subsequently decides whether to adopt the identified EBP. In addition, consideration is given to what might need to be adapted - at the system, organization, and/or individual level(s), and to the EBP itself.
In the Preparation phase, the primary objectives are to identify potential barriers and facilitators of implementation at the outer and inner contexts (described later), further assess needs for adaptation, and to develop a detailed plan to capitalize on implementation facilitators and address potential barriers. Critical within the Preparation phase is planning of implementation supports (e.g., coaching, audit and feedback) to facilitate use of the EBP in the next two phases (Implementation and Sustainment) and consideration of how best to develop an implementation climate that indicates that EBP use is expected, supported, and rewarded in the system and organization
In the Implementation phase and guided by the planned implementation supports from the Preparation phase, EBP use is initiated and instantiated in the system and/or organization(s). However, it is essential that ongoing monitoring of the implementation process is incorporated to assess how it is proceeding and to support efforts to adjust accordingly.
In the Sustainment phase, the outer and inner context structures, processes, and supports are ongoing so that the EBP continues to be delivered, with or without some adaptation, to realize the resulting public health impact of the implemented EBP.