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  • What is known about the role of external facilitators during the implementation of complex interventions in healthcare settings? A scoping review

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Evidence based practice
Original research
What is known about the role of external facilitators during the implementation of complex interventions in healthcare settings? A scoping review
  1. Ariane Girard1,
  2. Amélie Doucet2,
  3. Mireille Lambert3,
  4. Sarah Ouadfel3,
  5. Genève Caron4,
  6. Catherine Hudon3
  1. 1School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada
  2. 2Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
  3. 3Department of Family Medicine and Emergency, Université de Sherbrooke, Sherbrooke, Quebec, Canada
  4. 4Departement of Psychology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
  1. Correspondence to Dr Ariane Girard; ariane.girard2{at}usherbrooke.ca

Abstract

Objective To synthesise current knowledge about the role of external facilitators as an individual role during the implementation of complex interventions in healthcare settings.

Design A scoping review was conducted. We reviewed original studies (between 2000 and 2023) about implementing an evidence-based complex intervention in a healthcare setting using external facilitators to support the implementation process. An information specialist used the following databases for the search strategy: MEDLINE, CINAHL, APA PsycINFO, Academic Search Complete, EMBASE (Scopus), Business Source Complete and SocINDEX.

Results 36 reports were included for analysis, including 34 different complex interventions. We performed a mixed thematic analysis to synthesise the data. We identified two primary external facilitator roles: lead facilitator and process expert facilitator. Process expert external facilitators have specific responsibilities according to their role and expertise in supporting three main processes: clinical, change management and knowledge/research management.

Conclusions Future research should study processes supported by external facilitators and their relationship with facilitation strategies and implementation outcomes. Future systematic or realist reviews may also focus on outcomes and the effectiveness of external facilitation.

  • review
  • change management
  • implementation science

Data availability statement

No data are available.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2024-084883

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    Data availability statement

    No data are available.

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    Footnotes

    • Contributors All authors contributed to the redaction and the revision of the manuscript. CH conceptualised and co-led the study with AG. AG, SO and GC selected title and abstract, full-text articles and extracted data. ML and AD contributed to validating the data extract. AG and AD analysed the data. CH and ML validated the results. AG is acting as the garantor of the study.

    • Funding This work was supported by the Canadian Institutes of Health Research (CIHR)–Operating Grant: Strategy for Patient-Oriented Research (SPOR) Primary and Integrated Health Care Innovations (PIHCI) Network: Programmatic Grants (grant number 397896) and other partners such as Axe santé-population, organisations et pratiques du CRCHUS (NA), Centre de recherche du CHUS (NA), CIUSSS de l’Estrie-CHUS (NA), CIUSSS du Saguenay-Lac-St-Jean (NA), College of Family Physicians of Canada (NA), Département de médecine de famille et médecine d’urgence (Université de Sherbrooke) (NA), Fondation de l’Université de Sherbrooke (NA), Fondation de Ma Vie (NA), Fonds de recherche du Québec–Santé (NA), Government of Newfoundland and Labrador (NA), Government of New Brunswick (NA), Institut universitaire de première ligne en santé et services sociaux (NA), Maritime SPOR Support for People and Patient-Oriented Research and Trials (SUPPORT) Unit (NA), Ministère de la Santé et des Services sociaux of Quebec (NA), New Brunswick Health Research Foundation (NA), Nova Scotia Health Authority (NA), Faculty of Medicine Dalhousie University and Dalhousie Medical Research Foundation (NA), Réseau-1 Québec (NA), Research in Medicine Program at Dalhousie University (NA), Saskatchewan Health Research Foundation (NA), Sturgeon Lake First Nation–Health (NA), Université de Sherbrooke (NA) and Université du Québec à Chicoutimi (NA).

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.