Implementation Facilitation Tools & Resources

Supporting providers in delivering high quality care to patients

With the rapidly expanding body of biomedical research, changing clinical guidelines and recommendations, and emergence of novel technologies, frontline providers are navigating an untenable number of changes to ensure healthcare consumers receive the best possible care. A proactive, systematic approach is critical to support clinicians and medical facilities in providing evidence-based care.

Implementation facilitation (IF) is a multi-faceted process of enabling and supporting individuals, groups, and organizations in their efforts to adopt and incorporate evidence-based practices into routine care. The tools and resources described on this page can help providers and IF practitioners learn about and apply this strategy.

I. Implementation Facilitation Training Manual

Using Implementation Facilitation to Improve Healthcare Implementation Facilitation Training Manual (Version 3) is a comprehensive resource for individuals seeking to apply implementation facilitation to enhance the uptake of evidence-based practices in their organization.

Pearls of the Implementation Facilitation Manual:

• Incorporates implementation science and clinical operations expertise
• Provides practical recommendations for improving the uptake of evidence-based practices by targeting barriers at both the provider and organizational levels
• Reflects the latest IF research and theory and the real-world experiences of IF experts

We invite you to provide us with feedback and resources that may be helpful to others who are embarking on this journey! Please contact Katherine Dollar (Katherine.Dollar@va.gov) with any comments and/or materials.

Suggested citation:

Ritchie MJ, Dollar KM, Miller CJ, Smith JL, Oliver KA, Kim B, Connolly, SL, Woodward E, Ochoa-Olmos T, Day S, Lindsay JA, Kirchner JE. Using Implementation Facilitation to Improve Healthcare (Version 3). Veterans Health Administration, Behavioral Health Quality Enhancement Research Initiative (QUERI), 2020. Available at: https://www.queri.research.va.gov/tools/Facilitation-Manual.pdf.

II. Key Steps in Implementation Facilitation

The purpose of this addendum to the Implementation Facilitation Training Manual is to convey concise, high-level information about the process for applying an implementation facilitation strategy. It presents a list of key steps associated with most implementation facilitation efforts and builds upon information provided in the manual. This document provides specific locations in the Training Manual where users can find additional information about each of the key steps.

III. Implementation Facilitation Time and Activity Tracking Tool

The Implementation Facilitation (IF) Time Tracking Log is a templated Excel workbook that can be used to document facilitators' time and activities. The Excel file includes instructions for how to adapt and customize this tracking log for use in your project. For more information about tracking time and activities, see the IF Training Manual pages 107-109.

The activity codes included in the IF Time Tracking Log may also be used to document and assess facilitators' use of core IF activities for monitoring fidelity to the IF strategy. (See IF Training Manual pages 112-113.)

Suggested citation for the IF Time Tracking Log:

Ritchie MJ, Kirchner JE, Townsend JC, Pitcock JA, Dollar KM, Liu CF. Time and organizational cost for facilitating implementation of primary care mental health integration. Journal of General Internal Medicine 2020;35(4):1001-10. https://doi.org/10.1007/s11606-019-05537-y

Suggested citation for the core IF activities listed in the IF Time Tracking Log:

Smith JL, Ritchie MJ, Kim B, Miller CJ, Chinman M, Kelly PA, Landes SJ, Kirchner JE. Getting to fidelity: Consensus development process to identify core activities of implementation facilitation. Global Implementation Research and Applications 2024; https://doi.org/10.1007/s43477-024-00119-5

IV. Implementation Facilitation Literature Collection

The Implementation Facilitation (IF) Literature Collection consists of 510 peer-reviewed articles, published from 1996 through 2021, about application of facilitation as an implementation strategy for supporting the adoption, routine use, and sustainment of clinical innovations for improving healthcare delivery and outcomes. Articles include research studies (e.g., RCTs, hybrid effectiveness-implementation trials), examples of large-scale clinical initiatives, literature reviews, and conceptual/theoretical articles. The collection was created using rigorous, systematic methods, documented in the article cited below.

The collection will be useful to healthcare providers and IF practitioners seeking to understand IF and how it has been applied in research studies and clinical initiatives to implement evidence-based practices and other clinical innovations. The collection will also be useful to researchers seeking to: (a) understand conceptual/theoretical frameworks and models that have been used to guide use of IF strategies, (b) apply and evaluate the impact of IF strategies in their own research, and/or (c) synthesize findings or lessons learned across multiple IF studies.

The Implementation Facilitation Literature Collection list of articles and information about them is available in two forms:

• An Excel file (Table 2 in the Supplementary Material for the article cited below), which can be downloaded from: https://www.frontiersin.org/articles/10.3389/frhs.2024.1304694/full#supplementary-material

• A zipped XML file that can be saved to your personal files, unzipped and imported into your preferred citation management software (e.g., EndNote, Zotero, Mendeley, or RefWorks) or into Covidence, a web-based software platform that streamlines the production of systematic reviews.

Suggested citation:

Ritchie MJ, Smith JL, Kim B, Woodward EN, Kirchner JE. Building a shareable literature collection to advance the science and practice of implementation facilitation. Frontiers in Health Services. 2024;4:1304694. https://doi.org/10.3389/frhs.2024.1304694