Abstract:
BACKGROUND:Facilitation has been identified in the literature as a potentially key component of successful implementation. It has not, however, either been well-defined or well-studied. Significant questions remain about the operational definition of facilitation and about the relationship of facilitation to other interventions, especially to other change agent roles when used in multi-faceted implementation projects. Researchers who are part of the Quality Enhancement Research Initiative (QUERI) are actively exploring various approaches and processes, including facilitation, to enable implementation of best practices in the Veterans Health Administration health care system - the largest integrated healthcare system in the United States. This paper describes a systematic, retrospective evaluation of implementation-related facilitation experiences within QUERI, a quality improvement program developed by the US Department of Veterans Affairs. METHODS:A post-hoc evaluation was conducted through a series of semi-structured interviews to examine the concept of facilitation across several multi-site QUERI implementation studies. The interview process is based on a technique developed in the field of education, which systematically enhances learning through experience by stimulating recall and reflection regarding past complex activities. An iterative content analysis approach relative to a set of conceptually-based interview questions was used for data analysis. FINDINGS:Findings suggest that facilitation, within an implementation study initiated by a central change agency, is a deliberate and valued process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship. Facilitation was described primarily as a distinct role with a number of potentially crucial behaviors and activities. Data further suggest that external facilitators were likely to use or integrate other implementation interventions, while performing this problem-solving and supportive role. PRELIMINARY CONCLUSIONS: This evaluation provides evidence to suggest that facilitation could be considered a distinct implementation intervention, just as audit and feedback, educational outreach, or similar methods are considered to be discrete interventions. As such, facilitation should be well-defined and explicitly evaluated for its perceived usefulness within multi-intervention implementation projects. Additionally, researchers should better define the specific contribution of facilitation to the success of implementation in different types of projects, different types of sites, and with evidence and innovations of varying levels of strength and complexity.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Stetler CB,Legro MW,Rycroft-Malone J,Bowman C,Curran G,Guihan M,Hagedorn H,Pineros S,Wallace CMdoi
10.1186/1748-5908-1-23subject
Has Abstractpub_date
2006-10-18 00:00:00pages
23issn
1748-5908pii
1748-5908-1-23journal_volume
1pub_type
杂志文章abstract:BACKGROUND:The translation of research into policy and practice is enhanced by policymakers who can recognise and articulate their information needs and researchers that understand the policymakers' environment. As researchers, we sought to understand the policymaking process and how research evidence may contribute in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0315-0
更新日期:2015-09-03 00:00:00
abstract:BACKGROUND:One of the fastest growing risk groups for early onset of diabetes is women with a recent pregnancy complicated by gestational diabetes, and for this group, Latinas are the largest at-risk group in the USA. Although evidence-based interventions, such as the Diabetes Prevention Program (DPP), which focuses on...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0426-2
更新日期:2016-05-18 00:00:00
abstract::Implementing research findings into healthcare practice and policy is a complex process occurring in diverse contexts; it invariably depends on changing human behaviour in many parts of an intricate implementation system. Questions asked with the aim of improving implementation are multifarious variants of 'What works...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/s13012-017-0660-2
更新日期:2017-11-14 00:00:00
abstract:BACKGROUND:Osteoarthritis is a leading cause of pain and disability worldwide. Despite research supporting best practice, evidence-based guidelines are often not followed. Little is known about the implementation of non-surgical models of care in routine primary care practice. From a knowledge mobilisation perspective,...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01055-2
更新日期:2020-10-28 00:00:00
abstract:BACKGROUND:How humans think and make decisions is important in understanding behaviour. Hence an understanding of cognitive processes among physicians may inform our understanding of behaviour in relation to evidence implementation strategies. A personality theory, Cognitive-Experiential Self Theory (CEST) proposes a r...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-23
更新日期:2008-04-25 00:00:00
abstract:BACKGROUND:Like in many settings, implementation of evidence-based practices often fall short in pediatric intensive care units (PICU). Very few prior studies have applied implementation science frameworks to understand how best to improve practices in this unique environment. We used the relatively new integrated Prom...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-021-01080-9
更新日期:2021-01-28 00:00:00
abstract:BACKGROUND:Case management has emerged as a promising alternative approach to supplement traditional one-on-one sessions between patients and doctors for improving the quality of care in chronic diseases such as coronary heart disease (CHD). However, data are lacking in terms of its efficacy and cost-effectiveness when...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-21
更新日期:2006-09-27 00:00:00
abstract:BACKGROUND:More than a fifth of Australian children arrive at school developmentally vulnerable. To counteract this, the Healthy Kids Check (HKC), a one-off health assessment aimed at preschool children, was introduced in 2008 into Australian general practice. Delivery of services has, however, remained low. The Theore...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-9-60
更新日期:2014-05-23 00:00:00
abstract:BACKGROUND:Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility (SAFE) measure is a s...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0262-9
更新日期:2015-05-23 00:00:00
abstract:BACKGROUND:Experts recommend that alcohol-related care be integrated into primary care (PC) to improve prevention and treatment of unhealthy alcohol use. However, few healthcare systems offer such integrated care. To address this gap, implementation researchers and clinical leaders at Kaiser Permanente Washington (KPWA...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-018-0795-9
更新日期:2018-08-06 00:00:00
abstract:BACKGROUND:It is challenging to interpret the results of multifaceted interventions due to complex program theories that are difficult to measure in a quantifiable manner. The aims of this paper were, first, to develop a model for a comprehensive quantitative implementation evaluation and, second, to operationalize it ...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-018-0720-2
更新日期:2018-02-08 00:00:00
abstract:BACKGROUND:Effective web-assisted tobacco interventions (WATIs) have been underutilized by smokers; moreover, despite practice guideline recommendations, clinical teams do not routinely refer smokers to WATIs. Our goal was to test a clinical practice innovation, an ePortal designed to change practice and patient behavi...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-015-0336-8
更新日期:2015-11-02 00:00:00
abstract:BACKGROUND:Health practice guidelines (HPGs) are important tools for the translation of evidence into practice. Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist provides guidance on reporting health practice guidelines (HPGs). We assessed the reporting completeness and quality of a set of nationa...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0828-4
更新日期:2018-10-29 00:00:00
abstract:BACKGROUND:Healthcare systems are not well designed to help people maintain or improve their health. They are generally not person-focused or well-coordinated. The objective of this study is to evaluate the effectiveness of the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) approach ...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-016-0407-5
更新日期:2016-04-05 00:00:00
abstract::As more quality improvement programs are implemented to achieve gains in performance, the need to evaluate their lasting effects has become increasingly evident. However, such long-term follow-up evaluations are scarce in healthcare implementation science, being largely relegated to the "need for further research" sec...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-21
更新日期:2008-04-22 00:00:00
abstract:BACKGROUND:The Portuguese National Health Directorate has issued clinical practice guidelines on prescription of anti-inflammatory drugs, acid suppressive therapy, and antiplatelets. However, their effectiveness in changing actual practice is unknown. METHODS:The study will compare the effectiveness of educational out...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-9-10
更新日期:2014-01-15 00:00:00
abstract:BACKGROUND:Evidence-based practice (EBP) implementation represents a strategic change in organizations that requires effective leadership and alignment of leadership and organizational support across organizational levels. As such, there is a need for combining leadership development with organizational strategies to s...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-017-0562-3
更新日期:2017-03-03 00:00:00
abstract:BACKGROUND:The importance of behaviour change in improving health is illustrated by the increasing investment by funding bodies in the development and evaluation of complex interventions to change population, patient, and practitioner behaviours. The development of effective interventions is hampered by the absence of ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-10
更新日期:2011-02-07 00:00:00
abstract:BACKGROUND:A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful t...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-117
更新日期:2012-12-03 00:00:00
abstract::This paper presents the rationale and methods for a randomized controlled evaluation of web-based training in motivational interviewing, goal setting, and behavioral task assignment. Web-based training may be a practical and cost-effective way to address the need for large-scale mental health training in evidence-base...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-7-43
更新日期:2012-05-14 00:00:00
abstract:BACKGROUND:Implementation of multifaceted interventions typically involves many diverse elements working together in interrelated ways, including intervention components, implementation strategies, and features of local context. Given this real-world complexity, implementation researchers may be interested in a new mat...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01070-3
更新日期:2020-12-11 00:00:00
abstract:BACKGROUND:General dental practitioners (GDPs) regularly prescribe antibiotics to manage dental infections although most infections can be treated successfully by local measures. Published guidance to support GDPs to make appropriate prescribing decisions exists but there continues to be wide variation in dental antibi...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0372-z
更新日期:2016-01-29 00:00:00
abstract:BACKGROUND:Implementing change in primary care is difficult, and little practical guidance is available to assist small primary care practices. Methods to structure care and develop new roles are often needed to implement an evidence-based practice that improves care. This study explored the process of change used to i...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-3
更新日期:2008-01-16 00:00:00
abstract:BACKGROUND:The WISE (Whole System Informing Self-management Engagement) approach encompasses creating, finding, and implementing appropriate self-care support for people with long-term conditions. A training package for primary care to introduce the approach was developed and underwent formative evaluation. This entail...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-7
更新日期:2010-01-29 00:00:00
abstract:: Delirium occurs in up to 65% of older hip fracture patients. Developing delirium in hospital has been associated with a variety of adverse outcomes. Trials have shown that multi-component preventive interventions can lower delirium rates. The objective of this study was to implement and evaluate the effectiveness of ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-81
更新日期:2010-10-22 00:00:00
abstract:BACKGROUND:Hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygie...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-6-101
更新日期:2011-09-03 00:00:00
abstract::Implementation research (IR) is growing in recognition as an important generator of practical knowledge that can be translated into health policy. With its aim to answer questions about how to improve access to interventions that have been shown to work but have not reached many of the people who could benefit from th...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0527-y
更新日期:2016-12-09 00:00:00
abstract:BACKGROUND:Accurate measures of health professionals' clinical practice are critically important to guide health policy decisions, as well as for professional self-evaluation and for research-based investigation of clinical practice and process of care. It is often not feasible or ethical to measure behaviour through d...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-37
更新日期:2009-07-03 00:00:00
abstract:BACKGROUND:Adapting interventions that have worked elsewhere can save resources associated with developing new interventions for each specific context. While a developing body of evidence shows benefits of adapted interventions compared with interventions transported without adaptation, there are also examples of inter...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-019-0956-5
更新日期:2019-12-17 00:00:00
abstract:BACKGROUND:For early stage breast cancer, randomized controlled trials (RCTs) have shown that patient decision aids (PtDAs), when used by surgeons, result in increased patient knowledge about options and different patient treatment choices as compared to standard care. Yet, recent data suggests that PtDAs are used by l...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0174-0
更新日期:2014-11-29 00:00:00