Dimensions of implementation facilitation strategies: development of a tool for strategy development and specification

Abstract Background Implementation strategies are operationalized variably and often inadequately described in scientific literature, prompting calls for standardized reporting mechanisms. Implementation facilitation (IF) is a complex, multifaceted, and evidence-based implementation strategy that is one of the more commonly applied and evaluated. Identifying and defining the complete range of IF dimensions is foundational to establishing a more standardized approach to designing, operationalizing, and reporting of IF strategies. Such work will provide greater transparency and understanding of how the strategy is applied, as well as greater consistency in reporting. This paper describes the development of a tool to support designing, documenting, applying, and evaluating IF strategies. Methods IF experts used a rigorous, multi-phase development process to: 1) identify IF dimensions and create a prototype tool to support IF practitioners and researchers in the design, application, and evaluation of IF; 2) validate the prototype’s usefulness and functionality; 3) verify IF dimensions and how they were operationalized in relevant protocol papers; and 4) iteratively refine and enhance the prototype tool to create a final version (the Implementation Facilitation Dimensions Worksheet). Results We identified and defined thirteen IF dimensions. The final publicly available tool includes a structured worksheet that can be used to describe the dimensions of a planned or previously applied IF strategy, a table that lists and defines IF activities that can be used in implementation efforts, instructions and examples for operationalizing the IF dimensions, and a list of other related tools and resources. Our iterative processes of validation and verification produced significant improvements to the worksheet during its development, resulting in a tool found to be useful for planning and reporting on IF strategies. Conclusions The Implementation Facilitation Dimensions Worksheet provides guidance and a structured format to support the comprehensive design, documentation, and evaluation of IF strategies. If the tool achieves its intended purpose, to bring about greater standardization in documenting and reporting IF strategies, researchers and implementation practitioners should be better informed and equipped to make comparisons of IF strategies across studies and/or to replicate or spread successful IF strategies to other healthcare settings.