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Barriers and facilitators to the implementation of the collaborative method: reflections from a single site
P J Newton1, E J Halcomb, P M Davidson
1School of Nursing, University of Western Sydney, Locked Bag 1797, Penrith South DC, New South Wales 1797, Australia. phil_newton@wsahs.nsw.gov.au
Quality & Safety in Health Care
|December 7, 2007
Summary
Implementing a collaborative method for evidence-based practice requires strong leadership and communication. Addressing potential barriers and facilitators before starting is crucial for successful adoption and improved outcomes.
Area of Science:
- Healthcare improvement strategies
- Evidence-based practice implementation
- Multisite quality improvement initiatives
Background:
- Collaborative methods facilitate evidence-based practice sharing across multiple sites.
- Originating in the USA, collaborative approaches are now used internationally.
- This study examines a single site's experience within a state-wide heart failure collaborative.
Purpose of the Study:
- To identify facilitators and barriers to implementing the collaborative method.
- To document challenges and successes from a participating site's perspective.
- To inform future multisite quality improvement efforts.
Main Methods:
- Qualitative data collection through participant observation, reflective journaling, and key informant interviews.
- Quantitative monitoring of team performance using prespecified indicators.
- Mixed-methods approach to comprehensively assess implementation factors.
Main Results:
- Key barriers and facilitators identified include organizational factors, team dynamics, and leadership.
- Effective clinical leadership and communication were significant factors.
- Changes in physician behavior and networking dynamics also played a role.
Conclusions:
- Site-level success of the collaborative method depends on leadership, communication, and team cohesion.
- A preparatory phase addressing known barriers is essential before commencing collaborations.
- Further evaluation of process issues and implementation factors in diverse settings is warranted.
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