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Table 2 Quotes illustrating middle managers’ roles during implementation

From: Elucidating the influence of supervisors’ roles on implementation climate

Supporting quotes Notes
Diffusing information
Interviewee 1: So maybe our training just … didn’t go over the parts we need every day… like how to implement it and the daily processes maybe.
Interviewee 2: Or we got the training, and you didn’t have one for months.
Interviewee 1: So then you ask your supervisor, and so whatever they heard is what you do. (Intake, July 2016)
Example of diffusing information by relaying information to frontline clinicians
I asked a supervisor today-I said, Oh, are you coming to the Gateway CALL focus group today?” And s/he said, “What’s Gateway?” (Ongoing, July 2015) Example of lack of diffusion of information about an innovation
Synthesize information
But you also have to make sure that the worker understands what they’re reading because we have different levels of ability and skill levels within the unit. I mean, I’ve got one [worker] who’s been there for almost eight years, and I’ve got one who’s been there four weeks. …if that four weeker was to get one of these [cases], it’s like, okay we’re gonna have to sit down and we’re gonna have to explain the whole thing. So skill level of the worker and their experience goes into it. (Supervisors, July 2015) Example of synthesizing information by tailoring information to individual worker
I’ve had a case where [in-person] wasn’t an option. So [my supervisor] was like, “Well, if you could catch her on the phone, if you could get those questions and do it that way.” (Intake, July 2016) Demonstration of troubleshooting challenging cases and adapting to the local context
Mediating between strategy and day-to-day tasks
I guess, if things are really followed-up on, like how they’re supposed to be, so my supervisor’s aware that I [have a Gateway CALL case]. She asks, “Do you have it [the assessment] back? What are the recommendations?” Cuz’ then she puts in her notes. “Okay, what’s the next step? Who’s making the referral, you or CALL?” “CALL.” Okay, next month, “Is your kiddo linked with X, Y, and Z?” (Ongoing, July, 2015) Example of mediating by identifying specific activities for implementation
And I, as a supervisor, it’s hard to keep on top of them to make sure they have some of the key points that were mentioned in the Gateway CALL [assessment], so it just depends on that, and sometimes that takes even more time, because I have to decline the case plan because it didn’t include that information. (Supervisors, 2015) Illustration of mediating by monitoring implementation and providing feedback
Even when we have trouble scheduling. Which I did, several times. Or connecting with a caseworker. He was very, hands on in contacting them and just putting that little extra push, getting them to call me (Behavioral Health, July 2015) Example of mediating via engaging in implementation activities
Selling implementation
I think that the support is up high, but it’s not trickling down, …If it’s that important to them, then educate your workers, your employees on the importance of this program. So that that support trickles down. We have supervisors tell us, “What is this? We don’t know what this is, or why we’re doing it.” (Behavioral Health, July 2016) Example of implementation is not well sold within the organization