From Hierarchy to Integration: The ‘Hierarchy of Intervention Effectiveness’ to the ‘Framework for Effective Integration and Adoption’

Authors

  • Fatimah Lateef Senior Consultant, Dept of Emergency Medicine, Singapore General Hospital, Core Faculty, Emergency Medicine Residency, SingHealth, Professor, Duke NUS Graduate Medical School, Yong Loo Lin School of Medicine, National University of Singapore and Lee Kong Chian Medical School, Nanyang Technological University, Director, SingHealth Duke NUS Institute of Medical Simulation (SIMS), Faculty, Duke NUS Global Health Institute, Singapore Author
  • Goh Ying Hong Senior Assistant Manager, SingHealth Duke NUS Institute of Medical Simulation (SIMS), Singapore Author

DOI:

https://doi.org/10.47363/xerxrx47

Keywords:

Hierarchy , Integration, Intervention Effectiveness, Effective Integration, Adoption

Abstract

At work and in organizations, hierarchy often does not apply equally. Education and training is never a “one-size-fit-all”. The boundaries between systems-focused and people-focused interventions are becoming increasingly blurred today. The Hierarchy of Intervention Effectiveness (HIE) popularized by Lucian Leape and illustrated by Cassie McDaniel represents a risk management theory, with hierarchical ranks given to interventions; depicting that systems-focused interventions are more impactful and effective than human-focused ones.


We are proposing that the HIE be evolved to “The Framework for Effective Integration and Adoption”, for a variety of reasons, discussed in this paper. It aligns with the state of education and training today against the background of technological advancements.

Author Biographies

  • Fatimah Lateef, Senior Consultant, Dept of Emergency Medicine, Singapore General Hospital, Core Faculty, Emergency Medicine Residency, SingHealth, Professor, Duke NUS Graduate Medical School, Yong Loo Lin School of Medicine, National University of Singapore and Lee Kong Chian Medical School, Nanyang Technological University, Director, SingHealth Duke NUS Institute of Medical Simulation (SIMS), Faculty, Duke NUS Global Health Institute, Singapore

    Fatimah Lateef, Senior Consultant, Dept of Emergency Medicine, Singapore General Hospital, Core Faculty, Emergency Medicine Residency, SingHealth, Professor, Duke NUS Graduate Medical School, Yong Loo Lin School of Medicine, National University of Singapore and Lee Kong Chian Medical School, Nanyang Technological University, Director, SingHealth Duke NUS Institute of Medical Simulation (SIMS), Faculty, Duke NUS Global Health Institute, Singapore.

  • Goh Ying Hong, Senior Assistant Manager, SingHealth Duke NUS Institute of Medical Simulation (SIMS), Singapore

    Senior Assistant Manager, SingHealth Duke NUS Institute of Medical Simulation (SIMS), Singapore

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Published

2026-02-25

Issue

Vol. 5 No. 2 (2026): Volume 5 Issue 2

Section

Articles