Table 2.
Key Findings from Scoping Review of 94 Studies Applying an Implementation Facilitation Strategy
| Implementation Facilitation (IF) Activity | # of studies reporting use of activity (from 94 studies) | % (rank, with top 5 bolded) | # of studies identifying activity as ‘core’ (from 31 studies reporting ‘core’ activities) | % (rank, with top 5 bolded) | # of studies reporting use of the activity and positive implementation outcomesa | % (rank, with top 5 bolded)b | # of studies reporting use of the activity and positive process-of-care and/or patient outcomesa | % (rank, with top 5 bolded)b |
|---|---|---|---|---|---|---|---|---|
| Conduct ongoing monitoring of program implementation | 67 | 71% (1) | 12 | 39% (3) | 30/48 | 62.5 (13) | 22/48 | 45.8 (10) |
| Clinical skills education | 66 | 70% (2) | 9 | 29% (6) | 37/50 | 74.0 (4) | 24/50 | 48.0 (4) |
| Engaging stakeholders, obtaining buy-in | 63 | 67% (3) | 19 | 61% (1) | 31/46 | 67.4 (9) | 22/46 | 47.8 (5) |
| Data collection to assess context and baseline performance | 55 | 59% (4) | 15 | 48% (2) | 25/39 | 64.1 (11) | 20/39 | 51.3 (2) |
| Providing updates and feedback | 54 | 57% (5) | 9 | 29% (6) | 23/41 | 56.1 (14) | 19/41 | 46.3 (9) |
| Technical support | 54 | 57% (5) | 11 | 35% (4) | 27/40 | 67.5 (8) | 20/40 | 50.0 (3) |
| Action / implementation planning | 50 | 53% (6) | 10 | 32% (5) | 23/36 | 63.9 (12) | 16/36 | 44.4 (11) |
| Providing support | 49 | 52% (7) | 15 | 48% (2) | 26/38 | 68.4 (6) | 18/38 | 47.4 (6) |
| Problem-solving | 46 | 49% (8) | 10 | 32% (5) | 26/34 | 76.5 (2) | 16/34 | 47.1 (7) |
| Adapting program to local context without compromising fidelity | 41 | 44% (9) | 7 | 23% (8) | 20/27 | 74.1 (3) | 9/27 | 33.3 (13) |
| Goal/priority setting | 41 | 44% (9) | 8 | 26% (7) | 19/28 | 67.9 (7) | 11/28 | 39.3 (12) |
| Managing group/team processes | 40 | 43% (10) | 8 | 26% (7) | 21/30 | 70.0 (5) | 14/30 | 46.7 (8) |
| Fostering change (unspecified) | 39 | 41% (11) | 4 | 13% (10) | 17/26 | 65.4 (10) | 13/26 | 50.0 (3) |
| Administrative tasks | 34 | 36% (12) | 9 | 29% (6) | 20/25 | 80.0 (1) | 13/25 | 52.0 (1) |
| Problem identification | 33 | 35% (13) | 7 | 23% (8) | 17/23 | 73.9 | 13/23 | 56.5 |
| Organizational change skills education | 28 | 30% (14) | 9 | 29% (6) | 16/18 | 88.9 | 7/18 | 38.9 |
| Fostering peer networking | 26 | 28% (15) | 4 | 13% (10) | 17/21 | 81.0 | 9/21 | 42.9 |
| Marketing | 25 | 27% (16) | 5 | 16% (9) | 14/19 | 73.7 | 8/19 | 42.1 |
| Fostering organizational change: structural | 21 | 22% (17) | 3 | 10% (11) | 11/16 | 68.8 | 6/16 | 37.5 |
| Developing shared vision / consensus building | 17 | 18% (18) | 5 | 16% (9) | 8/10 | 80.0 | 2/10 | 20.0 |
| Interceding and liaising with others | 17 | 18% (18) | 3 | 10% (11) | 11/13 | 84.6 | 8/13 | 61.5 |
| Identification / selection of local change agents | 17 | 18% (18) | 1 | 3% (13) | 7/11 | 63.6 | 4/11 | 36.4 |
| Describing / clarifying roles and responsibilities | 15 | 16% (19) | 3 | 10% (11) | 7/12 | 58.3 | 7/12 | 58.3 |
| Fostering networking with experts | 14 | 15% (20) | 4 | 13% (10) | 6/8 | 75.0 | 2/8 | 25.0 |
| Overcoming resistance to change | 10 | 11% (21) | 4 | 13% (10) | 3/6 | 50.0 | 2/6 | 33.3 |
| Fostering organizational change: cultural | 9 | 10% (22) | 0 | – | 4/4 | 100.0 | 1/4 | 25.0 |
| Strategy/policy development | 6 | 6% (23) | 0 | – | 6/8 | 75.0 | 5/8 | 62.5 |
| Pulling back and letting sites take lead | 5 | 5% (24) | 2 | 6% (12) | 0/1 | – | 0/1 | – |
| Attending, presenting at and/or organizing non-local meetings | 3 | 3% (25) | 0 | – | 3/3 | 100.0 | 0/3 | – |
| Fostering spread of clinical innovation / facilitation methods | 2 | 2% (26) | 0 | – | 0/0 | – | 0/0 | – |
| Helping to hire clinical program staff | 2 | 2% (26) | 0 | – | 2/2 | 100.0 | 1/2 | 50.0 |
| Marketing education | 1 | 1% (27) | 0 | – | 0/1 | – | 0/1 | – |
For these columns, denominators are the number of studies that reported use of the activity AND reported outcomes. Examples of positive ‘implementation outcomes’ include items such as developing an action plan or implementation blueprint, establishing a patient registry, conducting a training, implementing a clinical reminder, developing patient education materials, etc. Examples of positive ‘process of care outcomes’ include improvements in prescribing, side effect monitoring, number of psychotherapy sessions, foot exams for people with diabetes, etc. Examples of positive ‘patient outcomes’ include improvements in symptoms, functioning, lab values, etc
For these columns, rankings are only provided for activities where denominator (number of studies) ≥ 25