Table 3

Results: characteristics (attributes) of facilitation, n=133 articles

Rogers’ attribute of an innovation	Characteristics of facilitation	Illustrative examples from the literature
Relative advantage	Facilitation could be considered advantageous because it is described in the literature as a process for making change easier for others by: (1) encouraging assessment of current practice, (2) presenting ideas to others, (3) creating useful communication networks, and (4) providing support and resources to achieve goals	Encourages assessment of current practice Encourages the assessment of current practice/performance gaps4 32 101 140–142 Helps others understand gaps between the knowledge and practice of the target audience36 171 Helps individuals and teams to understand what they need to change and how they need to change it in order to apply evidence into practice17 101 145 146 Facilitation occurs in the context of a recognised need for improvement (eg, supports best practice)4 56 77 143–145 Presents ideas to others Introduces the existence of desirable new ideas and enhances the knowledge base about new ideas48 67 78 79 148 Creates useful communication networks Facilitates effective communication56 57 159 205 Establishes/navigates communication channels4 60 128 152 Networks with other health professionals about best practices143 180 205 Provides support and resources to achieve goals Facilitator as ongoing support or resource4 30 41 48 49 56 57 78 86 92 94 95 133 141 142 147–156 Offers or identifies resources to assist with the process of change32 33 44 78 142 151 156 190 198 Monitors progress.56 57 111 147 Builds organisational support for new practices151 157 Provides structure for learning33 Supports a goal-oriented process4 118
Compatibility	A key purpose of facilitation is to make change more compatible with existing practice. There are several characteristics of facilitation that promote compatibility with existing practice including: (5) mobilising existing knowledge and skills, (6) enhancing staff readiness for change and empowering staff, (7) supporting/promoting a culture for change, and (8) tailoring facilitation activities to local context, needs and circumstances	Mobilising existing knowledge and skills94 Enhances staff readiness for change; empowers staff Increases perceptions of professional acceptability and subjective norms35 Enables individuals and teams to analyse, reflect and change their own attitudes, behaviours and ways of working3 66 Facilitator belief that the change is needed59 76 Facilitator framed knowledge so that it was relevant to staff practice158 Empowers staff to be equal participants95 121 141 159 Supports and promotes a culture for change; creates a supportive climate; creates a vision for research use/evidence-based practice Creates a local climate in which research activities are encouraged128 130 160 Creates a culture to sustain the implemented change40 44 45 75 128 130 144 145 161 165 Addresses and develops organisational systems20 and infrastructure to facilitate success of the innovation148 153 Facilitator must understand the practical realities of healthcare and clinical settings99 164 Helps others make choices based on their own context134 Addresses individual concerns and helps others to change behaviour through the provision of information or evidence66 Creates and supports an organisational vision for evidence-based practice62 163 Tailors facilitation activities to local context, needs and circumstances Facilitator helps the group to consider and address the local issues that might negatively affect the use of the recommendations166 Facilitation activities tailored to local context, needs and circumstances49 50 56 61 75 103 142 150 165–171
Complexity	Facilitation can assist others with the implementation process. Facilitation capitalises on existing skills and (9) supports the development of new knowledge and skills, (10) requires facilitators to be trained or have experience with this role, (11) may comprise several strategies, and (12) is described as a bidirectional process that fosters relationship building	Supports the development of new knowledge and skills Supports the development of new knowledge and/or skills45 68 78 79 94 99 108 114 126 128 150 156 165 170 171 181 191 196 208 Helps staff to learn to access and/or appraise evidence to answer clinical questions and apply it to their practice21 52 83 122 161 200 Assesses and meets staff learning needs70 201 Guides the learners33 Facilitator training Ongoing support for the facilitator role18 48 56 57 82 94 129 209 Facilitators require training*32 37 46–48 68 69 102–107 118–120 129 133–139 Facilitators are experienced mentors,75 90 140 153 and must have a basic knowledge of the problems experienced by staff101 119 141 175 194 206 210 More than one facilitator (champion) was needed when an improvement required people to change behaviours151 Multiple components Use of multiple strategies (eg, reminders and a nurse facilitator)47 48 84 142 185 (eg, opinion leader education and audit and feedback)63 Bidirectional process Facilitation is proactive and dynamic211 Facilitation drives a process of change19 30 56 130 141; a two-way process of communication, building relationships/reciprocal relationships,203 and mutual goals and opportunities4 An iterative process in which the next step is informed by the conditions preceding it74 Flexible and purposeful4 A process of interactive problem solving4 56 73 Internal/external facilitation or a combination thereof3 17 18 20 21 49 146 176† Enabling approach3 4 20 21 146 176
Trialability	The literature provided some examples of facilitation interventions that were pilot tested on a small scale prior to full implementation	Pilot test; feasibility studies46 90 103 105 118 138 149 150 163 174 177–179
Observability	Observability reflects whether one can see the results of facilitation, that is, observing an individual using research as a result of facilitation. Observable characteristics of facilitation identified in the literature were: (13) facilitators encouraging others to role model the change (use of research evidence) and (14) maintaining momentum by reinforcing change	Role models the change33 45 56 68 78 86 99 126 180–182 Maintains the momentum and encourages/motivates staff in the process33 86 139 152 153 181 194 198 203 by reinforcing the change/75 108 109 184and supporting sustainability18 27

*Intervention studies.
†Theoretical literature—PARiHS framework/i-PARiHS.