Facilitation in evidence implementation - experiences, challenges, and determinants of perceived effectiveness: a qualitative systematic review.

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2023-12-01 DOI:10.1097/XEB.0000000000000399
Lucylynn Lizarondo, Alexa McArthur, Demetrius Porche, Marleen Corremans, Beatrice Perrenoud, Rogério Rodrigues, Craig Lockwood
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Abstract

Introduction: Facilitation is a key element of evidence implementation. Although quantitative systematic reviews have been undertaken to examine its components and effectiveness, no attempt has been made to synthesize qualitative evidence examining the experiences of facilitators on how facilitation is operationalized, the challenges associated with it, and the factors that can influence its perceived effectiveness.

Methods: A systematic review of qualitative studies was conducted using the JBI methodology.

Results: A total of 36 qualitative studies was included in the systematic review, with the majority being assessed as high quality following critical appraisal. The findings were extracted and further synthesized, highlighting that facilitation involves providing technical and non-technical support to health professionals, as well as high-intensity collaborations and relationship building. Determinants of perceived effectiveness of facilitation include facilitators' access to resources and learning support; their skills, traits/attitudes, and approach to facilitation; and the context of the organization where the implementation occurs. Work demands, emotional stress, and lack of clarity in roles and career development can pose challenges for facilitators.

Conclusion: To maximize the outcomes of facilitation in evidence implementation, the team of facilitators should be carefully selected to ensure they have the right skills, traits/attitudes, and approach to facilitation. They should also be provided with dedicated time to conduct the facilitation and have access to resources, training, and mentoring support. Future research should aim to examine the perspectives of the "implementers" who received support from facilitators to gain a better understanding of which facilitation strategies have an impact on clinical practice behavior.

Review registration number: PROSPERO CRD42023402496.

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促进证据实施-经验,挑战和感知有效性的决定因素:定性系统回顾。
导言:促进是证据实施的关键要素。虽然已经进行了定量系统审查,以检查其组成部分和有效性,但没有尝试综合定性证据,审查促进者在如何实施促进、与之相关的挑战以及可能影响其感知有效性的因素方面的经验。方法:采用JBI方法对定性研究进行系统回顾。结果:共有36项定性研究被纳入系统评价,其中大多数被评价为高质量。对调查结果进行了摘录和进一步综合,强调促进工作涉及向卫生专业人员提供技术和非技术支助,以及高强度合作和建立关系。促进效果感知的决定因素包括促进者获得资源和学习支持的机会;他们的技能、特点/态度和促进的方法;以及实现发生的组织环境。工作需求、情绪压力、角色和职业发展不清晰,都可能给引导者带来挑战。结论:为了最大限度地提高证据实施中的促进效果,应仔细选择促进者团队,以确保他们具有正确的技能、特征/态度和促进方法。他们还应该有专门的时间来进行促进,并有机会获得资源、培训和指导支持。未来的研究应着眼于考察获得促进者支持的“实施者”的观点,以更好地理解哪些促进策略对临床实践行为有影响。审核注册号:PROSPERO CRD42023402496。
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CiteScore
3.20
自引率
13.00%
发文量
23
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