Implementation of Safe Patient Handling in the U.S. Veterans Health System: A Qualitative Study of Internal Facilitators’ Perceptions

Abstract

Internal facilitation is both an implementation intervention and a process involving a wide range of activities. The findings provide an understanding of what internal facilitators are doing to support practice changes and the characteristics and skills of internal facilitators that are likely to result in long-term organizational change. Five recommendations for action address organizations, senior leaders, and internal facilitators.

Implementing TeamSTEPPS in small rural hospitals

“…Following the review and a taxonomy developed by Dogherty and colleagues (2010), a stream of literature focused on the facilitation activities. These studies identified more than 50 specific activities and categorized them across four implementation stages -planning for change, leading and managing change, monitoring progress and ongoing implementation, and evaluating change (Dogherty et al, 2010(Dogherty et al, , 2014Elnitsky et al, 2015). These studies also showed that both internal and external facilitators engage in facilitation activities (Dogherty et al, 2012) and they work as both individuals and groups (Dogherty et al, 2010(Dogherty et al, , 2012Elnitsky et al, 2015).…”

“…These studies identified more than 50 specific activities and categorized them across four implementation stages -planning for change, leading and managing change, monitoring progress and ongoing implementation, and evaluating change (Dogherty et al, 2010(Dogherty et al, , 2014Elnitsky et al, 2015). These studies also showed that both internal and external facilitators engage in facilitation activities (Dogherty et al, 2012) and they work as both individuals and groups (Dogherty et al, 2010(Dogherty et al, , 2012Elnitsky et al, 2015). Dogherty and colleagues (2014) noted that the literature on facilitation activities typically examines external facilitation and facilitation initiated by the researchers, and concluded that more studies need to examine internal facilitation activities as they unfold in their natural setting.…”

“…While subsequent studies helped refine this model (e.g. Dogherty et al, 2012;Elnitsky et al, 2015), it is limited in its ability to further our understanding of implementation processes from the variance model perspective. To overcome this limitation, I identified types of facilitation activities that unfolded over time, and the characteristics that distinguish them.…”

“…Several studies have examined facilitation activities empirically and identified more than 50 specific activities across several implementation stages (Dogherty et al, 2010(Dogherty et al, , 2014Elnitsky et al, 2015). The activities start with planning for change (e.g.…”

“…linking implementation to patient outcomes, acknowledging success). These studies found that facilitation efforts involve both internal and external facilitators (Dogherty et al, 2012) who work both as individuals and groups (Dogherty et al, 2010(Dogherty et al, , 2012Elnitsky et al, 2015). Bidassie and colleagues found that facilitation activities change over time, from assessing the context, relationship building and providing tools early on, to encouraging and cheerleading, celebrating successes and creating ownership to sustain changes towards the end.…”