Table 3

HSI decision making (HSI-DM) guide and checklist

Step	Objective	Actions	Resources	Progress
1. Define the HSI activity: QI, HMR, or THMR?	Local, national or international issue identified as an organisational priority.	Refer to table 1 Health system improvement continuum and table 2 Exemplar health management projects across the HSI continuum.	NA
2. Decide the outcome of the proposed activity	Contribution to local industry and or academic knowledge.	Review organisational material to identify priority issue.	Board minutes, strategic plans, policies and procedures, media releases, social media.
		Assess government resources to align with identified priority issue.	Annual reports, issues papers, proposal documents, websites.
		Establish a network with key stakeholders to create the research team.	Discussions with credible, knowledgeable persons within and associated with the organisation.
3. Define a clear aim	Activity aims or questions clearly defined.	Ensure link to organisation strategic vision, values and priorities.	Strategic, corporate and operational plans.
4. Ground the study in evidence	Combination of academic, organisational and industry evidence	Source peer reviewed evidence from multidisciplinary health and business databases to establish the academic base.	Databases including Scopus, Google Scholar, ProQuest, PubMed, Business Elite, Cochrane, CINAHL.
4. Ground the study in evidence		Explore grey literature to ascertain emerging practice.	Think tanks, international bodies for example, WHO, international sources for grey literature including WorldCat, Bielefeld Academic Search Engine (BASE) and Open Grey.
5. Determine methodology	Plan how the improvement activity will occur, identify relevant stakeholders, resources required and anticipated timeline.	Design an achievable project with identifiable and accessible evidence.	Organisational data collection points, publicly available comparative data sources, validated data collection tools, QI or ethics processes.
		Engage appropriate stakeholders and steps to implement the activity and solutions.	Relevant staff, patients, consumer groups and external agencies in the planning, executing and reporting of the activity.
		Dedicate sufficient resources.	In kind and external resources to achieve the desired outcomes, within a mapped time frame.
6. Scope dissemination plan	Implementation strategies for improvement.	Disseminate the implications of findings across the various levels and stakeholders in the health system.	Determine the level of engagement with various stakeholders and ascertain appropriate communications methods.

HMR, health management research; HSI, health system improvement; QI, quality improvement; THMR, translational health management research.