Table 2 Facilitation strategies used by change facilitators to overcome common implementation barriers in community pharmacy
Strategy category to overcome barrier* | Facilitation strategies within category | Most common barriers overcome using this strategy category (PRP)a |
|---|---|---|
Empower stakeholders to develop objectives and solve •lems | • Stimulate critical inquiry/ critical reflection • Utilise think-aloud process • Utilise brainstorming techniques • Outlining opportunities presented by change • Conduct a needs analysis • Conduct a Strength, Weaknesses, Opportunities and Threats (SWOT) analysis • Use prioritisation techniques • Introduce goal-setting (SMART goals) • Use consensus-building/shared decision-making • Providing solutions/advice • Create/ recommend the creation of a monthly or annual plan • Ensure win/win goals (mutually beneficial solutions) • Use an action planner tool • Use a mind-mapping tool • Discuss/ outline best practices | • An inability to plan for change (80.64%) • A lack of internal supporters of the change (73.44%) • A lack of individual alignment with the change (83.13%) • Undefined change objectives and lack of objective feedback (80.55%) • A lack of time (62.25%) |
Engage stakeholders by creating ownership of the change | • Establish/ allocate roles • Delegate responsibilities • Allocate primary champion and/or supporting champions • Define key performance indicators • Ask for commitment to the agreed changes • Encourage collaboration and teamwork • Recommend or aid in conducting a performance review • Allocate roles based on skills/ interests • Emphasise the importance of delegating | • An inability to plan for change (84.23%) • A lack of internal supporters of the change (78.29%) • A lack of individual alignment with the change (49.38%) |
Equip stakeholders with training | • Provide/recommend skills/technical training • Provide knowledge training • Conduct/ recommend role-playing/role modelling • Bringing subject matter expert • Refer to external formal education/training • Using case studies • Use a staff scoping and training tool • Encourage discussion of training topic as a group • Create/adapt training plan • Determine training gaps • Encourage self-learning (e.g reading of journals) | • A lack of knowledge and experience related to the change (93.44%) • An inability to plan for change (83.30%) |
Adapt area of focus to meet change needs | • Adapt task allocations by creating a roster to align with change • Improve workflow by adapting layout to cater for change • Adapt vision/mission to align for change • Review roles to align with change requirements • Create time-tabling (annual, monthly or weekly time tables) • Adapt business strategy plan to the change • Adapt image of organisation towards new changes • Create/adapt communication plan to new changes • Adapt process/procedures to new changes • Encourage regular communication amongst participants to ensure everyone is aligned to new changes | • An inability to plan for change (81.17%) • A lack of time (79.09%) |
Create buy-in amongst stakeholders | • Ask about individual concerns regarding the change • Address specific individual concerns related to the change • Motivate group/individuals using stories • Compare audit results to network benchmarking results • Emphasise enhanced customer outcomes as opposed to poor practice • Outline negative impacts to lack of implementation (using evidence/opinion) • Outlining benefits of implementation (using evidence/opinion) | • A lack of individual alignment with the change (82.86%) • A lack of internal supporters of the change (57.90%) |
Create a collaborative environment conducive to change | • Organise or conduct meetings (face-to-face) • Lead virtual meeting (coach present digitally e.g. webinar or skype) | • A lack of knowledge and experience related to the change (99.80%) |
Feedback progress of implementation measures | • Provide constructive feedback • Acknowledge success/recognise/celebrate achievements • Provide ongoing encouragement | • A lack of monitoring and feedback regarding the change (99.12%) |
Ensure stakeholders contribute to the change | • Acknowledge ideas • Encourage knowledge/experience sharing • Involve others in the change process • Acknowledge the importance of individuals’ roles | • A lack of individual alignment with the change (98.79%) |
Ensure continuous monitoring of implementation measures | • Monitor financial impact • Measure and monitor customer outcomes • Monitor service provision • Monitor Staff measures • Emphasise ongoing monitoring by stakeholders • Monitor agreed upon plan/objectives • Display progress chart | • A lack of monitoring and feedback of the change (68.09%) |
Communicate the change to stakeholders | • Inform the entire group of the change and objectives verbally • Inform individuals of the change and objectives verbally • Inform using a visual display such as poster • Inform using a written document (email, letter, etc). | • Undefined change objectives and lack of objective feedback (62.83%) |