Implementation support practitioners help to make organizational learning a core value of the implementation setting.

They support the use of quantitative and qualitative feedback at each stage of implementation through regular stakeholder debriefings, dedicating time for reflection, shared learning and improvements along the way. Ongoing feedback on programs and practices involves using practical, relevant measures of progress and considering the differential impact of interventions across populations and communities. When data are not available, implementation support practitioners work with services and practitioners to collect and analyse information needed to support decision-making and improvement.

Core competencies that support ongoing improvement include:

  • Assessing needs and assets
  • Understanding context
  • Applying and integrating implementation frameworks, strategies, and approaches
  • Facilitation
  • Communication
  • Conducting improvement cycles

Assessing Needs and Assets Competency

Implementation support practitioners should have the competency to:

  • Work with stakeholders to understand population and community assets and needs and the extent to which potential programs and practices meet identified needs for particular focus populations.
  • Value the perspectives of multiple stakeholders when identifying needs and considering potential programs and practices to address needs and improve outcomes.
  • Assess issues of need through an equity lens in order to consider how a program or practice, and the implementation support provided, can advance equitable outcomes for the different individuals, families and communities that form its focus population.

Key Activities - Assessing Needs and Assets

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

  • Identify the needs that different stakeholders involved in an implementation want to see met through the change process.
  • Support the identification of readily available and potential resources and assets to be utilised and leveraged in the implementation context.
  • Help stakeholders understand each other’s perspectives and expectations regarding the area of need or opportunity.
  • Use data-driven inquiry methods to support ‘discovery’ processes that holistically consider need, such as assessment data, stakeholder analysis, mapping of existing services, initiative inventory, etc.
  • Disaggregate available evidence and data and assess, consider and discuss needs that may exist for particular subpopulations (e.g., race, ethnicity, gender, socioeconomic status, geography).
  • Engage people with lived experience in determining needs.

Helpful Hint - Assessing Needs and Assets

Implementation support practitioners value a multi-faceted assessment of needs and assets that includes the perspective of multiple stakeholders.

For example, implementation support practitioners may conduct mapping of existing services to reach a common understanding of existing services, good practice and service gaps/needs which are not being met. Implementation support practitioners will also gather information from people with lived experience to determine if the mapping exercise yielded findings that align with the experiences of the focus population, and support the integration of findings for service selection.

Understanding Context

Implementation support practitioners should have the competency to:

  • Conduct assessments of contextual fit between proposed programs and practices and the local service settings before moving forward with implementation. Contextual factors that should be considered include:
    • current initiatives and priorities of the site
    • local history and community values
    • organizational capacity to deliver potential programs and practices
  • Link assessing context with considerations of diversity, equity and inclusion. Disparate outcomes and community context cannot be accurately understood without acknowledging structural and institutional racism and other mechanisms of discrimination.

Key Activities - Understanding Context

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

  • Involve diverse stakeholders from throughout the system – including those belonging to specific subgroups – in identifying and understanding the implications and consequences of change efforts.
  • Use and/or conduct evidence reviews to determine rele¬vance and fit of the proposed intervention(s) / approach(es) with identified needs and assets.
  • Assess the contextual fit of the proposed intervention(s)/approach(es) with the values, needs, skills and resourc¬es available in the service setting, including in specific subgroups.
  • Assess the contextual fit of the proposed intervention(s)/approach(es) with the current political, funding and organizational landscape.
  • Continuously identify and respond to changes in the system(s) surrounding the implementation, which affect implementation.
  • Identify and support mitigating actions to anticipate and manage risks and assumptions for the change effort (e.g. regarding resources, commitments or buyin; risks or loss for different stakeholders).

Helpful Hint - Understanding Context

Implementation is influenced by the service system and community context. With this in mind, implementation support practitioners should regularly assess the contextual fit of a specific evidence-informed program or practice to help implementing sites determine if and how it is likely that the intervention will be sustained in their service environment.

Multiple implementation frameworks provide excellent starting points to think about contextual influences.

Applying and Integrating Implementation Frameworks, Strategies and Approaches Competency

Implementation support practitioners should have the competency to apply and integrate different implementation frameworks and strategies most suitable for a particu¬lar context or setting to support implementation sites in meeting their goals.

In selecting relevant implementation frameworks and strategies, implementation support practitioners use systems thinking, participatory methods, and knowledge management and exchange:

  • Systems thinking involves examining how implementation efforts fit within a whole system and choosing appro¬priate approaches to address potential problems and issues.
  • Participatory methods rec¬ognise that key stakeholders should contribute to choosing, designing, and using implementation strategies.
  • Knowledge management and exchange includes summarising and synthesising how a range of implementation strategies can address critical implementation barriers and advance implementation goals.

Key Activities - Applying and Integrating Implementation Frameworks, Strategies and Approaches

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

  • Remain up to date on evidence developed through implementation research and practice.
  • Remain up to date on knowledge about implementation frameworks, models, theories, and strategies.
  • Educate stakeholders about the current best evidence on implementation frameworks, strategies and approaches.
  • Include all relevant stakeholders in the selection, combination and co-design of implementation strategies and approaches.
  • In collaboration with relevant stakeholders, assess and discuss the appropriateness of using implementation frameworks, strategies and approaches in different contexts and settings, including with particular subgroups.
  • Support the selection, application and integration of the range of implementation frame¬works, approaches, tools and resources that are best suited for the local context of service and policy settings.

Helpful Hint - Applying and Integrating Implementation Frameworks, Strategies and Approaches

Implementation support practitioners explore the benefits of different implementation frameworks, models and strategies with implementation teams and governance structures to address specific implementation goals.

Part of the tailoring process for implementation support involves developing a unique package of implementation strategies to meet the unique needs of the implementing site.

Facilitation

Implementation support practitioners should have the competency to:

  • Enable implementation-related problem solving, that is participatory, involves supportive interpersonal relationships and recognises a need for improve¬ment.
  • Facilitate meetings with the following goals in mind:
    • ensuring full participation of all relevant stakeholders.
    • encouraging all stakeholders to share their perspectives.
    • enabling mutual understanding among stakeholders to accept the legitimacy of one another’s needs and goals.
    • developing inclusive solutions that emerge from the integration of everybody’s perspectives and needs.
    • promoting shared responsibility of stakeholders to implement proposals they endorse and to give and receive input before final decisions are made.

Key Activities - Facilitation

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

  • Create welcoming and engaging spaces for all participants in meetings and other facilitation activities, recognising that participants may require different kinds of support to feel welcome and participate in facilitation processes.
  • Support a communication protocol and process that facilitates interactions among stakeholders. Support the continuous and systematic identification of barriers to implementation among different stakeholders.
  • Enable the identification of stakeholders required to develop adequate strategies for solving implementation challenges.
  • Serve as formal and informal facilitators as determined by an analysis of the challenge and its context.
  • Support a balance of divergent and convergent thinking among team members, depending on the type of challenge faced.
  • For easily named and easily solved challenges (technical challenges), support stakeholders to evaluate alternatives, summarise key points, sort ideas into categories, and exercise judgement.
  • For complex challenges with no easy solution (adaptive challenges), support stakeholders to generate alternatives, free flow open discussion, gather diverse points of view, and suspend judgement.
  • Ensure that the facilitation method used matches the challenge in focus (e.g. structured facilitation, free flowing group discussions, etc.).
  • When needed, respond to emergent discussions or challenges with ad hoc, nimble facilitation.

Helpful Hint - Facilitation

Implementation support practitioners lift up the expertise and experience of the stakeholders at the implementing site to help solve implementation challenges. One of the ways they do this is through facilitation.

The facilitator’s job is to support everyone to do their best thinking and practice. By supporting everyone to do their best thinking, implementation support practitioners enable group members to search for inclusive solutions and build sustainable agreements.

Communication

Implementation support practitioners should have the competency to:

  • Support communication between stakeholders at every stage of implementation. Communication should include what is working, what is not working and how those conclusions were drawn.
  • Facilitate communication themselves. upport implementation teams to communicate and use timely feedback loops with key stakeholders.
  • Simultaneously seek to build the capacity of different implementation stakeholders to fully develop and deliver an “audience-based” implementation communication.

Key Activities - Communication

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

  • Work with stakeholders to develop communication protocols designed to:
    • intentionally engage stakeholders
    • communicate progress and celebrate implementation success
    • report systemic barriers that are preventing or hindering implementation
    • report on actions taken to resolve or address implementation challenges
    • revisit past decisions and agreements periodically to ensure that solutions are still appropriate.
  • Support the development of different communication protocols for different target groups, which specify communication goals, the method and frequency of communication, who needs to communicate, how effectiveness of communication will be measured, and how communication will consistently be improved.
  • Recognise and respond to differences in communication needs across different stakeholders involved, e.g. due to different organizational roles, implementation expectations, involvement and responsibilities.
  • Help implementation stakeholders to recognize and respond to differences in communication needs among focus populations through the implementation. These differences may be due to, for example, varying levels of language proficiency and literacy, different gender-, education-, or culture-based norms and preferences etc.
  • Encourage stakeholders to regularly communicate with and gather feedback from actors within and outside the implementing system to understand how implementation processes are perceived. As part of this process:
    • Support effective communication and feedback loops among practice, supervision, management, and leadership levels of the system (i.e., vertical feedback loops that support communication up and down a system).
    • Support effective communication and feedback loops among service partners, advocacy groups, training networks, representatives from the focus population, and other collaborators (i.e., horizontal feedback loops that support communication across system sectors).
  • Help to identify local communication barriers or complications and work with relevant implementation stakeholders to resolve these challenges.

Helpful Hint - Communication

Communication is important in terms of both information exchange and creating shared understandings.

With both of these objectives in mind, implementation support practitioners seek to build the capacity of implementing sites to communicate internally and externally about their implementation successes and challenges. One way they do this is by helping implementing sites develop communication protocols that address when communication is needed, by whom, why, and in what format.

Implementation support practitioners may also support leaders in developing their implementation communication aimed at ensuring that quality implementation and active engagement in implementation activities is expected, supported and rewarded.

Conducting Improvement Cycles

Implementation support practitioners should have the competency to:

  • Use data to purposefully prepare and reexamine implementation processes and contin-uously improve practice, organization and systems changes.
  • Conduct cyclical tests of change aiming to iteratively improve the implementation process.
  • Enable an implementation team and stakeholders to value and use both the anticipated and unexpected learnings of iterative cycles.

Key Activities - Conducting Improvement Cycles

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

  • Facilitate the ongoing testing and improvement of tools, products, processes, governance structures, service models, and policies of relevance to implementation efforts.
  • Help to identify, and gather relevant quantitative and qualitative data about the progress and quality of implementation activities and outcomes.
  • Ensure that different stakeholders have access to relevant, valid and reliable data on how the program or practice and accompanying implementation strategies are functioning to guide decision-making along the way.
  • Support the development of processes and structures for the routine collection and analysis of these data.
  • Promote the collection and use of data suitable to understand the differential impact of interventions and their implementation on different focus populations and communities.
  • Develop stakeholders’ capacity to continuously assess and use data for decision-making about the ongoing planning, implementation, and outcomes of a program or practice through modelling, instruction and coaching.
  • Support the development of structures that ensure that stakeholders regularly dedicate time to reflecting on or debriefing about available data throughout an implementation as a strategy to promote shared learning and improvements along the way.
  • Support implementation stakeholders in their data-based decision-making, including the prioritisation of needs and challenges, and the development of concrete solutions to identified problems.
  • Help to create feedback loops that connect leadership with frontline service, and policy with practice and/or research, and ensure that improvements made during implementation are communicated to all stakeholders.

Helpful Hint - Conducting Improvement Cycles

Implementation support practitioners help leaders and teams develop processes for gathering and understanding information about what is helping or hindering implementation efforts. This often involves deciding on monitoring and evaluation processes.

For example, implementation support practitioners may help to identify administrative data already existing in the organization or system, and assess its usability as indicators of implementation progress or quality. Implementation support practitioners may also need to source valid and reliable instruments developed to measure such progress.

The work with improvement cycles also involves helping to define the intervention or implementation changes needed to optimise the ongoing work.

Central to this improvement work is dedicated time, allowing stakeholders to pause and reflect throughtout the implementation process. Intentional reflection and reexamination of implementation processes often do not happen without the explicit support of an implementation support practitioner.