Humber River Hospital is an acute care facility that has used continuous monitoring to determine the impact of BPG implementation and staff performance. 

DongZhiMen Hospital and Beijing University of Chinese Medicine (BUCM) School of Nursing are international BPSOs in Beijing, China. Staff at the sites identified barriers to the use of evidence in practice including heavy workloads, cultural differences and reluctant attitudes about using evidence to inform practice.   

As one of the preconditions of social movement action, this element focuses on strategies to root the change as meaningful and urgently needed. 

A key feature of the Leading Change Toolkit is the inclusion of two complementary implementation frameworks. Combined, the Social Movement Action (SMA) Framework and the Knowledge-to-Action (KTA) Framework, create a powerful, novel approach that can support you and your change team to lead a practice change using an evidence-based resource, like an RNAO best practice guideline (BPG).

The Social Movement Action Framework is an evidence-based implementation framework focusing on engaging groups of people through mobilized grassroots actions to achieve goals. 

A key characteristic of the Social Movement Action Framework is "Collective identity" in which individuals engaged in a change initiative develop a shared identity that acts as a powerful driver or 'glue' for their continued commitment to the change and taking action. 

One of the key characteristics of the Social Movement Action Framework is networks of people and resources; these act as supportive mechanisms to access and share tools, ideas and energy to advance change. 

One of the key characteristics of the Social Movement Action Framework is momentum. This article page describes this element in detail. 

A key characteristic of the Social Movement Action Framework is core leadership structures (or change teams) whose role is to support the guidance and leadership of the change with input and action from others. 

An outcome of the Social Movement Action Framework' is scaling in which the change initiative is spread, widened or normalized.