Implementation support practitioners promote and facilitate the active involvement of stakeholders in all stages of the design and implementation process resulting in service models, approaches, and practices that are contextualised and tailored to settings. This is to ensure that programs, practices, and implementation work match the values, needs, skills, and resources of those delivering programs and practices, systems stakeholders, and service beneficiaries.

Core competencies that support co-creation include:

  • Co-learning
  • Brokering
  • Addressing power differentials
  • Co-design
  • Tailoring support

Co-learning Competency

Implementation support practitioners should have the competency to:

  • Work collaboratively with systems stakeholders to learn how knowledge on implementation science can be effectively used in the local context.
  • Actively seek to learn about the culture, history, and current priorities in the local context in order to assess the most feasible and relevant uses of implementation science.
  • Support learning among stakeholders at the implementing site and recommend specific implementation strategies based on local context and conditions.

Key Activities - Co-learning

The key activities which implementation support practitioners conduct, relating to the Co-learning competency, include:

  • Understand the system and organizational context and culture.
  • Create spaces for new ideas to emerge. Negotiate and build trust and respect for all perspectives, including those that may be at risk of being excluded from dialogue because of race, ethnicity, language or status.
  • Communicate and listen for the purpose of mutual understanding and the collaborative integration of different perspectives and types of knowledge.
  • Synthesise diverse perspectives of thought and check for understanding.
  • Conduct dynamic and interactive trainings and provide educational materials on implementation science.
  • Seek other ways to introduce and create readiness for an implementation science informed approach that fits with existing programs, practices and processes.

Helpful Hint -
Co-learning

Implementation support practitioners enter the implementation space as a co-learner seeking to understand the priorities of the implementing site(s). For example, implementation support practitioners support the collaborative development of logic models and implementation plans which enables teams/stakeholders to learn together and agree what they want to achieve (outcomes), the interventions being delivered and the implementation methods. It is important to involve different disciplines and perspectives in the process. The process is as important as the outputs (the logic model and/or the implementation plan).

Brokering Competency

Implementation support practitioners should have the competency to:

  • Enable knowledge exchange and information sharing among stakeholders to increase understanding of diverse perspectives related to the design and implementation of the program or practice.
  • Pool information and leverage resources to enable decision making across the organization or service system.

Key Activities - Brokering

The key activities which implementation support practitioners conduct, relating to the Brokering competency, include:

  • Position yourself as a bridge “in between” people or groups that exist in a system and are vital for the success of an implementation
  • Identify individuals or groups that are relevant to involve in the implementation but not yet part of it and seek to understand the root causes and contributing factors of that disconnect
  • Connect otherwise disconnected individuals or groups in the system by providing advice and serving as a relational resource
  • Develop and regularly convene implementation groups and teams with diverse stakeholders
  • Promote other network weaving to connect people strategically where there is a potential of mutual benefit
  • Source, share and translate evidence and data of relevance to involved stakeholders
  • Promote opportunities for stakeholders and team members to engage with others in the use of evidence and data

Helpful Hint - Brokering

Implementation support practitioners identify siloes within the service system and find ways to bring stakeholders together across the siloes. For example, an implementation support practitioner may bridge connections between referring agencies and services agencies to strengthen the referral process and access to services for the focus population.

An implementation support practitioner may also connect agencies or practitioners using a novel intervention for the first time with more experienced users from a different organization or systems to enable collective learning. Brokering can also involve implementation support practitioners liaising between research institutions and practice / services as part of academiccommunity partnerships.

Addressing Power Differentials

Implementation support practitioners should have the competency to address power imbalances between community members and stakeholders in the wider system by:

  • Building trust
  • Supporting two-way communication
  • Cultivating opportunities for mutual consultation
  • Identifying accountabilities

Key Activities - Addressing Power Differentials

The key activities which implementation support practitioners conduct, relating to this competency, include:

  • Position the range of service beneficiary experiences at the center of decisionmaking and implementation activities.
  • Identify the influence that different stakeholders may have on the implementation.
  • Pay particular attention to those with inherently greater power to influence the implementation process and those disenfranchised from the implementation process.
  • Use facilitation techniques to make power structures visible and to protect all voices in the implementation process.
  • Recognise and acknowledge the loss of status and authority that may be implied in an implementation process and can impede buy-in and engagement.
  • Seek and gain buy-in from formal and informal leaders to include diverse expertise in team discussions. Develop an evolving ‘collective view’ or ‘shared understanding,’ rather than pushing for an artificial consensus which may perpetuate existing power structures.

Helpful Hint - Addressing Power Differentials

Implementation support practitioners often need to identify power issues that may impact their ability to provide implementation support and/or others’ ability to engage with and gain from this support. Power differentials exist when individuals involved in the implementation support (are perceived to) have greater authority, agency or influence than others.

Implementation support practitioners need to consider whether such differentials exist, and how they can be addressed. For example, by finding ways to gather and use feedback for implementation planning and improvement from all hierarchical roles of an organization or system, including practitioners as well as senior, middle and frontline leaders. In gathering this feedback, different roles may need to be involved separately to ensure they can speak freely.

Other power differentials to consider when providing implementation support are those between, for example, different professions (e.g. social work, medicine, nursing); service professionals and service users; different gender identities or different ethnicities.

Co-design

Implementation support practitioners should have the competency to:

  • Promote the co-design of practices, programs and their implementation.
  • Facilitate co-design processes among stakeholders at the implementing site, thereby including leaders, practitioners, and people with lived experience.
  • Co-design implementation tools, resources, and models through iterative processes and collective sense making.

Key Activities - Co-design

The key activities which implementation support practitioners conduct, relating to the Co-design competency, include:

  • Work with stakeholders to build a strong fit between intervention and implementation context before moving forward with implementation efforts.
  • Support collaborative implementation planning and co-development of an implementation blueprint or plan involving all relevant stakeholders.
  • Enable the co-design of any tools, products, processes, governance structures, service models, interventions and policies related to the implementation.
  • Promote cyclical tests of tools, products and processes among stakeholders to iteratively improve their prototypes.
  • Support the co-design and/or modification of specific implementation strategies based on resources and conditions present in the local context.
  • Facilitate design-centered activities that have the needs of people with lived experience at the centre, using collective sense-making and negotiation.

Helpful Hint -
Co-design

Implementation support practitioners should work with practitioners and service users to co-design and develop accessible tools, resources and products that are informed by evidence from research, practice and service users.

Implementation support practitioners may do this by facilitating design meetings where tools and resources are developed in real time, involving multiple perspectives. When these tools and resources are being tested, these stakeholders would also be engaged in gathering feedback on how they experienced and perceived these tools and resources when used in practice.

Tailoring Support

Implementation support practitioners should have the competency to:

  • Help to tailor the implementation strategies used by these stakeholders, based on a deep understanding of local actors and context
  • Tailor their own support to implementation stakeholders
  • Determine the frequency, duration and intensity of their implementation support based on the needs, goals and context of their stakeholders, and refrain from assumptions that a certain level and type of support is always needed

Key Activities - Tailoring Support

The key activities which implementation support practitioners conduct, relating to this competency, include:

  • Regularly assess the implementation support needs and asssets of different stakeholder groups.
  • Agree on the implementation support to be made available to different stakeholder groups, sites and/or other relevant units of support.
  • Develop a scope and sequence of virtual and onsite meetings and other activities based on the goals of those supported.
  • Accommodate “ad hoc” / “just in time” support needs of stakeholders.
  • Regularly assess the effectiveness of the level of your support in matching needs, goals, and context of the implementation effort.
  • Work with implementation stakeholders to select, combine and tailor their implementation strategies to meet local needs.
  • Continuously promote the adaptability of implementation strategies used by stakeholders.

Helpful Hint - Tailoring Support

Implementation support practitioners should work with practitioners and service users to co-design and develop accessible tools, resources and products that are informed by evidence from research, practice and service users.

Implementation support practitioners may do this by facilitating design meetings where tools and resources are developed in real time, involving multiple perspectives. When these tools and resources are being tested, these stakeholders would also be engaged in gathering feedback on how they experienced and perceived these tools and resources when used in practice.