QUERI – Quality Enhancement Research Initiative

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Implementation Facilitation Training Manual (Version 2)

Implementation Facilitation Training Manual: Using External and Internal Facilitation to Improve Care in the Veterans Health Administration Download (4 MB, PDF)

Using External and Internal Facilitation to Improve Care in the Veterans Health Administration

Implementing evidence-based practices and programs, indeed any complex clinical innovation, is challenging. Facilitation is a strategy with proven success in supporting implementation efforts. Facilitation has been widely used in many fields (e.g., management, education, social work, community development, mediation, as well as healthcare). Typically, we think about facilitation as a process of working with groups to support participatory ways of doing things. Group facilitators are generally experts in the process of helping groups, e.g., make decisions and identify and solve problems. Although group facilitation may be used to support implementation efforts, it may not be sufficient to help complex healthcare organizations make the changes needed for improved clinical practice. This manual focuses on implementation facilitation, a multi-faceted process of enabling and supporting individuals, groups and organizations in their efforts to adopt and incorporate clinical innovations into routine practices. Facilitation can incorporate or include many other implementation strategies, e.g., audit and feedback, education and training, and stakeholder engagement.

The purpose of this manual is to 1) provide information and resources for individuals seeking to understand the processes, and 2) support the development of the skills needed to help organizations implement clinical innovations.

The manual incorporates implementation science and clinical operations expertise and includes practical recommendations for applying evidence-based implementation strategies that can improve uptake of evidence-based clinical practices by targeting barriers at the provider or health care organization levels. Although there are other publicly available materials that serve the same purpose, this manual also provides practical guidance for supporting implementation of clinical innovations within Veterans Health Administration (VHA) facilities.

This manual is a work in progress and will be informed by future findings from implementation facilitation studies as well as possibly your own experiences. We invite you to provide us with feedback and materials or resources that may be helpful to others who are embarking on this journey (send to mona.ritchie@va.gov). We encourage you to share this manual or the link to it with others, both in and outside of VHA.

Ritchie MJ, Dollar KM, Miller CJ, Oliver KA, Smith JL, Lindsay JA, Kirchner JE. Using Implementation Facilitation to Improve Care in the Veterans Health Administration (Version 2). Veterans Health Administration, Quality Enhancement Research Initiative (QUERI) for Team-Based Behavioral Health, 2017. Available at: https://www.queri.research.va.gov/tools/implementation/Facilitation-Manual.pdf