Elnitsky C A, Powell-Cope G, Besterman-Dahan K L, Rugs D, Ullrich P M
Associate Professor, The University of North Carolina at Charlotte, Charlotte, NC.
Research Associate, Health Services Research and Development Center of Innovation for Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans Hospital, Tampa, FL.
Worldviews Evid Based Nurs. 2015 Aug;12(4):208-16. doi: 10.1111/wvn.12098. Epub 2015 Jul 28.
Although the literature has noted the positive effects of facilitation in implementation research, little is known about what facilitators do or how they increase adoption of a program. The purpose of this study was to understand internal facilitation activities in implementing a national safe patient handling program from the perspective of facility coordinators who implemented the program.
Using a qualitative descriptive design, data were collected in five focus groups at two international Safe Patient Handling and Mobility Conferences. Participants were 38 facility coordinators implementing a safe patient handling program in the Department of Veterans Affairs medical centers throughout the United States. Data were analyzed using direct content analysis to gather descriptions of internal facilitation.
The internal facilitation process involved engaging multiple disciplines and levels of leadership for implementation. Fifty-four facilitation activities were identified, including five activities not currently listed in an existing taxonomy. Key characteristics and skills of facilitators included persistence, credibility and clinical experience, and leadership and project management experience. Themes were mapped onto an existing framework and taxonomy of facilitation activities.
Internal facilitation is both an implementation intervention and a process involving a wide range of activities. The findings provide an understanding of what internal facilitators are doing to support practice changes and the characteristics and skills of internal facilitators that are likely to result in long-term organizational change. Five recommendations for action address organizations, senior leaders, and internal facilitators.
尽管文献中已指出促进措施在实施研究中的积极作用，但对于促进者的工作内容以及他们如何提高项目采用率却知之甚少。本研究的目的是从实施该项目的机构协调员的角度，了解在实施一项全国性安全患者搬运项目过程中的内部促进活动。
采用定性描述性设计，在两次国际安全患者搬运与移动会议的五个焦点小组中收集数据。参与者为在美国退伍军人事务部医疗中心实施安全患者搬运项目的38名机构协调员。使用直接内容分析法对数据进行分析，以收集内部促进措施的描述。
内部促进过程涉及让多个学科和不同层级的领导参与实施。共确定了54项促进活动，其中包括现有分类法中目前未列出的五项活动。促进者的关键特征和技能包括坚持不懈、可信度和临床经验，以及领导能力和项目管理经验。相关主题被映射到现有的促进活动框架和分类法中。
内部促进既是一种实施干预措施，也是一个涉及广泛活动的过程。这些发现有助于理解内部促进者为支持实践变革所做的工作，以及可能导致长期组织变革的内部促进者的特征和技能。针对组织、高层领导和内部促进者提出了五项行动建议。
