Dimensions of implementation facilitation (IF): development of a tool for designing, documenting and reporting on IF...

Implementation strategies are operationalized variably and often inadequately described in scientific literature, prompting calls for standardized reporting mechanisms. Implementation facilitation (IF) is a complex, multifaceted, and evidence-based implementation strategy that is one of the more frequently applied and evaluated. Identifying and defining the complete range of IF dimensions is foundational to establishing a more standardized approach to designing, documenting, and reporting on IF strategies. Such work will provide greater transparency and understanding of how the strategy is applied, as well as greater consistency in reporting. This paper describes the development of a tool to support such a standardized approach to IF design, documentation, and reporting in healthcare settings.

We used a rigorous, multi-phase process to develop and refine a tool to support IF practitioners and researchers in designing, documenting, and reporting on an IF strategy. We validated the tool's usefulness; verified current reporting of IF dimensions and how they were described in relevant protocol papers; and iteratively refined and enhanced the tool to create the Implementation Facilitation Dimensions Worksheet.

We identified and defined thirteen IF dimensions, including Position; IF skills, innovation knowledge, and characteristics; Self-efficacy; Activities; Autonomy/degree of flexibility; Duration; Frequency/intensity; Modes of interaction/mediums used; Role/approach; Change agents; Other stakeholders; Sources of influence; and Resources that support the facilitator. The final publicly available tool includes a structured worksheet that can be used to describe the dimensions of a planned or previously applied IF strategy, a table that lists and defines IF activities that can be used in implementation efforts, instructions and examples for operationalizing the IF dimensions, and a list of other related tools and resources.

The Implementation Facilitation Dimensions Worksheet provides guidance and a structured format intended to support the comprehensive design, documentation, and reporting of IF strategies. If the tool achieves its intended purpose, researchers and implementation practitioners may be better informed and equipped to make comparisons of IF strategies across studies and/or to replicate or spread successful IF strategies to other healthcare settings.