Open AccessWhat Influences Sustainment and Nonsustainment of Facilitation Activities in Implementation? Analysis of Organizational Factors in Hospitals Implementing TeamSTEPPS
Author(s) -
Jure Baloh,
Xi Zhu,
Marcia M. Ward
Publication year - 2019
Publication title -
medical care research and review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.433
H-Index - 85
eISSN - 1552-6801
pISSN - 1077-5587
DOI - 10.1177/1077558719848267
Subject(s) - facilitator , facilitation , process management , qualitative research , operations management , psychology , knowledge management , nursing , medicine , business , computer science , social psychology , engineering , sociology , social science , neuroscience
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.