International Practice Development Journal


Title of ArticleFactors enabling and inhibiting facilitator development: lessons learned from Essentials of Care in South Eastern Sydney Local Health District
Type of ArticleOriginal Practice Development and Research
Author/sTamera Watling
ReferenceVolume 5 , Issue 2, Article 3
Date of PublicationNovember 2015
Keywordschange management, facilitation, leadership, practice development, quality improvement, staff engagement, workplace culture

Background: Building and sustaining facilitation capacity for the creation of person-centred workplace cultures is a strategic priority of the South Eastern Sydney Local Health District Nursing and Midwifery Practice and Workforce Unit. Skilled facilitation is considered critical to the successful implementation and sustainability of practice development-based programmes, including Essentials of Care. Review of facilitator activity across the district revealed that less than half of those who had participated in a facilitation development programme were actively applying their knowledge to the facilitation of Essentials of Care.

Aim: To understand the enablers and barriers to the development and application of facilitation skills and the implementation of Essentials of Care from the perspective of the programme’s facilitators. The purpose was to inform ongoing strategies to build and sustain facilitation capacity for its effective implementation.

Method: A 21-question qualitative survey was designed using Survey Monkey. Questions were framed to allow free text responses for qualitative content analysis. Ethics approval was applied for and deemed unnecessary by the local health district ethics committee; the committee deemed the project to be a quality improvement activity not requiring independent ethical review. The survey was distributed electronically to 230 health professionals who had participated in the facilitation development programme between 2008 and 2013.

Findings: The key enablers for both facilitator development and implementation of Essentials of Care were time, engagement of staff and leadership support. Additional enablers for facilitation development included access to development opportunities and practical application of skills. Facilitation was an enabler of Essentials of Care implementation. Leadership support is pivotal, especially where time and patient acuity impinge on the release of staff for facilitated activities.

Conclusion: Facilitators need to be enabled to access training, practise their skills and learn from more experienced facilitators. There are parallels between the enablers of progress of the implementation of Essentials of Care and those to promote the development of facilitation capacity. Organisational leaders have a significant role in supporting both; it is critical they ensure there is a team of facilitators to share the workload, that time is allocated for facilitators to be released from clinical duties for development opportunities, and that there  is time for teams to engage in programme activities.

Implications for practice:

  • Findings suggest a relationship between facilitation capacity, context and the progression of practice development-based work. This evaluation offers practical examples that inform how these elements may be enhanced for the successful pursuit of person-centred healthcare practice
  • Managers and those in leadership positions have a key role in overcoming the contextual factors that inhibit facilitator development and programme implementation
  • Organisational planning and accountability to manage staffing, ensure optimal workloads and promote practice development work as a priority supports the engagement and motivation of staff to participate in programme activities, and therefore the capacity of teams to progress practice development work and transform culture and practice
  • The engagement of managers and those in leadership positions to clarify roles and responsibilities and establish agreed mechanisms for support of individuals and teams should precede the implementation of practice development programmes
  • Time is a significant resource in the successful advancement of facilitator development and programmes underpinned by practice development. In healthcare contexts, where staff feel time poor in the presence of the increasing demands of patient care, the pressure of multiple improvement programmes and other professional development requirements, there is an opportunity to explore the concept of time and how its negative impact on the progress of practice development work can be minimised

This article by Tamera Watling is licensed under a Creative Commons Attribution Non-Commercial 3.0 License.

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