Table 1 Implementation facilitation skills, descriptions, and related skills
From: From novice to expert: a qualitative study of implementation facilitation skills
Facilitation skills | Descriptions of skills | Skills that are included |
|---|---|---|
Communication skills | Interacting with individuals and groups, orally or in writing, to share information, e.g., through formal presentations, less formal conversations, emails, messages, and reports; listening to stakeholders; and asking questions to understand their needs and concerns | None |
Skill group 1: Building relationships and creating a supportive environment | ||
 Interpersonal skills | Interacting with stakeholders in positive ways, e.g., listening to stakeholders and ensuring they have opportunities to express their opinions, deferring to them when appropriate, working around their schedules, assessing and addressing their needs and concerns, and knowing when and how to be assertive and still be supportive | Assessment, communication |
 Stakeholder engagement | Involving stakeholders (individuals/teams that can affect or will be affected by the innovation) and fostering participation in planning and implementation processes, as well as tailoring interactions to their needs | Assessment, communication, education and marketing, interpersonal, motivating and building confidence, political |
 Motivating/building confidence | Praising stakeholders for participation and implementation progress and encouraging them to assess their own efforts, share their successes, solve problems, and create their own strategies | Communication, interpersonal |
 Political skills | Assessing, understanding, navigating, and leveraging the political dynamics of the setting | Assessment, communication, interpersonal, problem identification/solving |
 Interacting and working with leaders | Combining and applying all of the skills in this group to obtain the support and involvement of leaders, includes being comfortable with leadership at all levels, adopting a power stance when appropriate, and being respectful of leaders’ time and supportive of their decisions | Communication, stakeholder engagement, interpersonal, motivating and building confidence, political, pulling back and disengaging |
Skill group 2: Changing the system of care and structures and processes that support it | ||
 Helping to design/adapt a program to meet local needs | Helping stakeholders plan a PCMHI program that fits with local needs and available resources and further adapt the program based on implementation progress and outcomes data and emerging barriers and enablers | Assessment, communication, interpersonal, leading and managing team processes, presenting and using data, problem identification/solving |
 Problem identification and solving skills | Identifying and addressing problems and helping stakeholders identify and address problems, e.g., lack of space, implementation resources, leadership support, and stakeholder participation | Assessment, presenting and using data, stakeholder engagement |
 Presenting/using data to improve the program | Reviewing, interpreting, and presenting qualitative and quantitative information and using this information, e.g., to support and encourage stakeholder efforts, plan interventions to improve implementation, and support problem identification | Communication, interpersonal, monitoring implementation, stakeholder engagement, thinking strategically and planning |
 Helping integrate the program into other programs/services | Identifying and collaborating with leaders/staff of programs whose patients might need PCMHI services, who may provide additional services for PCMHI patients, or who may benefit from knowledge of the PCMHI program, to support sustainability after active implementation | Assessment, communication, interpersonal, leading and managing team processes, thinking strategically and planning |
Skill group 3: Transferring knowledge and skills and creating infrastructure support for ongoing learning | ||
 Education/marketing skills | Persuasively presenting and discussing PCMHI models, how they work, and the evidence for them; their value, benefits, and outcomes; and how to implement them, including how to address implementation challenges, as well as tailoring content and process to stakeholder needs and concerns | Assessment, communication, interpersonal |
 Training, mentoring, and coaching skills | Using training, mentoring, and coaching techniques to transfer skills to clinicians and leaders for providing PCMHI services, e.g., for delivering evidence-based PCMHI care models, rather than traditional mental healthcare, and increasing the number of PCMHI patients | Assessment, communication, education and marketing, learning and fostering learning, monitoring implementation |
 Learning and fostering learning skills | Applying learning strategies (e.g., learning from experts, others similar to yourself, and from past experiences) to fill in gaps in knowledge and build on existing knowledge and skills, and fostering stakeholder use of these strategies | None |
 Building learning collaboratives | Building a learning collaborative for PCMHI clinicians to support implementation by encouraging participation, facilitating meetings/calls, and encouraging members to share their own experiences and problems, work on solutions, and develop best practices | Communication, education and marketing, interpersonal, learning and fostering learning, pulling back and disengaging |
Skill group 4: Planning and leading change efforts | ||
 Administrative and project management skills | Performing technical tasks, e.g., working with sites to plan and schedule site visits and conference calls and disseminating materials and site visit reports, and pushing implementation forward when stakeholders/sites were not responding, or implementation processes were stalled | Interpersonal, monitoring implementation, political, and problem identification/solving |
 Meeting facilities and individuals where they are | Accepting and working with site and stakeholder limitations, building on their strengths, and helping them be as successful as possible | Interpersonal |
 Leading/managing team processes | Facilitating communication and managing conflict/disruptive behavior; guiding team processes, e.g., by sharing ideas, affirming stakeholder input, fostering team self-management; and leading task-oriented processes, e.g., goal setting, program design and adaptation, decision-making, and problem identification and solving | Assessment, communication, interpersonal, problem identification/solving, stakeholder engagement |
 Thinking strategically and planning | Thinking through what was currently happening at sites, what needed to happen for successful implementation, and how facilitators could help; planning/preparing for implementation events; and diagnosing/evaluating sites and implementation processes | Administrative and project management, assessment, monitoring implementation, problem identification/solving |
 Pulling back and disengaging | Gaging when stakeholders are ready to assume responsibility for implementation efforts and refraining from acting as the expert, deferring decision-making to leaders, helping stakeholders explore options and come to consensus, and saying good-bye | Assessment, interpersonal |
Skill group 5: Assessing people, processes, and outcomes and creating infrastructure for program monitoring | ||
 Organizational and individual assessment skills | Gathering information about and assessing the organizational context, including demographics, current practices, leadership structure/support, and relevant policies and procedures that could influence implementation and assessing stakeholders, interpersonal and group dynamics, and other factors | Communication |
 Developing a program monitoring system | Helping sites identify measures for assessing/monitoring provider productivity, program utilization, and outcomes; identifying, accessing, and obtaining data from existing databases; and developing/preparing feedback reports for monitoring, adapting, and improving the program | Administrative and project management, assessment, communication, engaging stakeholders, learning and fostering learning |
 Monitoring program implementation status | Continually observing implementation progress by reading and interpreting data in feedback reports; assessing program fidelity to evidence-based care, compliance with VA policy and fit with organizational context; and assessing implementation barriers and enablers | Assessment, developing a program monitoring system, problem identification/solving |