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. 2021 Apr;78(2):146-156.
doi: 10.1177/1077558719848267. Epub 2019 May 16.

What Influences Sustainment and Nonsustainment of Facilitation Activities in Implementation? Analysis of Organizational Factors in Hospitals Implementing TeamSTEPPS

Jure Baloh  1 , Xi Zhu  2 , Marcia M Ward  2
Affiliations

What Influences Sustainment and Nonsustainment of Facilitation Activities in Implementation? Analysis of Organizational Factors in Hospitals Implementing TeamSTEPPS

Jure Baloh et al. Med Care Res Rev. 2021 Apr.

Abstract

Implementation processes are often long and complex, requiring sustained facilitation efforts. Drawing on organizational and implementation literature, we examined the influence of senior management support (SMS), middle management support (MMS), facilitator team time availability (TIME) and team continuity (CONTINUITY) on sustainment of internal facilitation activities. For 2 years, we followed 10 small rural hospitals implementing TeamSTEPPS, a patient safety program, and conducted quarterly interviews with key informants. We coded, calibrated, and analyzed the data using the fuzzy-set qualitative comparative analysis. We found that five hospitals sustained facilitation activities and the combination of SMS, MMS, and CONTINUITY (i.e., presence of all three factors) was a sufficient condition for sustainment. Five other hospitals did not sustain facilitation activities and they either lacked MMS or lacked both TIME and CONTINUITY. In follow-up analyses, we found that team leadership continuity also influenced sustainment patterns. We discussed the implications for research and practice.

Keywords: TeamSTEPPS; facilitation; fsQCA; hospitals; implementation; sustainment.

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Conflict of interest statement

Declaration of Conflicting Interests:

The Authors declare that there is no conflict of interest.

Figures

Figure 1:
Figure 1:
Organizational Factors of Sustainment of Facilitation Activities
Figure 2:
Figure 2:
Venn Diagram of Conditions Sufficient for Sustainment of Facilitation Activities
See this image and copyright information in PMC

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