About HAIF

About the Framework

The Hospital Acupuncture Implementation Framework (HAIF) is a collaborative innovation that grew out of a partnership between RMIT University and Northern Health, led by Professor Zhen Zheng, PhD. It was developed during Professor Zheng's NHMRC Translating Research into Practice (TRIP) Fellowship (App 1110446), drawing on implementation science and hands-on experience from an acupressure project for post-operative nausea and vomiting (PONV).

HAIF has since been applied to a new initiative — PANDA (Personalised Acupuncture in the Northern Hospital Emergency Department for Acute Pain) — extending the framework from peri-operative care into acute emergency medicine.

What is HAIF?

The Hospital Acupuncture Implementation Framework is a structured methodology for integrating acupuncture and acupressure into hospital clinical practice. It guides implementation teams — including anaesthetists, surgeons, nurses, and acupuncturists — through four sequential phases:

1. Exploration — identifying human and environmental factors
2. Preparation — developing strategies for enablers and barriers
3. Implementation — executing the plan with internal and external support
4. Sustainment — normalising practice into routine operations

Theoretical Foundations

HAIF is grounded in two established implementation science frameworks:

• EPIS Model (Exploration, Preparation, Implementation, Sustainment) — provides the four-phase structure that organises the implementation process from initial evidence review through long-term sustainability.
• CFIR (Consolidated Framework for Implementation Research) — supplies the constructs used within each phase to assess organisational readiness, structural characteristics, leadership engagement, training access, and fidelity monitoring.

These frameworks are widely used in health services research and ensure that HAIF addresses known barriers and enablers for clinical practice change in a systematic, reproducible manner.

Acknowledgements

The development of this framework and website was supported by a Seed Grant from Research and Innovation, RMIT University.

The content draws on the collaborative work of the team that implemented acupressure for post-operative nausea and vomiting at Northern Hospital, Victoria, integrating implementation science expertise, acupuncture and acupressure evidence, and team learning. HAIF is a collaborative innovation between RMIT University and Northern Health, led by Professor Zhen Zheng.

Funding Sources

• NHMRC Translating Research into Practice (TRIP) Fellowship to Professor Zhen Zheng (App 1110446)
• RMIT University Postgraduate Scholarship to Ms Jenny Layton
• Internal funding from the School of Health and Biomedical Sciences, RMIT University
• In-kind support from the Surgery and Anaesthesia Departments at Northern Hospital, Victoria

Contributors

Dr Li Ping Thong (RMIT School of Design) created the original POPA4Ease website design. The team thanks the nurses, doctors, and other staff at Northern Hospital who made the implementation project possible.

Conflict of Interest Disclosure

Professor Zhen Zheng receives no financial benefit from the recommendation of any specific acupuncture or acupressure product, device, or training programme. The HAIF framework is developed as a public-good research output. Funding sources (NHMRC, RMIT University) had no role in the framework design, content, or recommendations.

This website does not sell products, accept advertising, or receive industry sponsorship. Evidence summaries are based on published systematic reviews and meta-analyses and are graded using the GRADE methodology.

Last reviewed: April 2026