Facilitation activities for change response: a qualitative study on infection prevention and control professionals during a pandemic in Brazil

Luís Irgang,Fábio Gama,Petra Svedberg,Magnus Holmén

doi:10.1108/jhom-12-2020-0506

Abstract

PurposeFacilitation activities support implementation of evidence-based interventions within healthcare organizations. Few studies have attempted to understand how facilitation activities are performed to promote the uptake of evidence-based interventions in hospitals from resource-poor countries during crises such as pandemics. This paper aims to explore facilitation activities by infection prevention and control (IPC) professionals in 16 hospitals from 9 states in Brazil during the COVID-19 pandemic.Design/methodology/approachPrimary and secondary data were collected between March and December 2020. Semi-structured interviews were conducted with 21 IPC professionals in Brazilian hospitals during the COVID-19 pandemic. Public and internal documents were used for data triangulation. The data were analyzed through thematic analysis technique.FindingsBuilding on the change response theory, this study explores the facilitation activities from the cognitive, behavioral and affective aspects. The facilitation activities are grouped in three overarching dimensions: (1) creating and sustaining legitimacy to continuous and rapid changes, (2) fostering capabilities for continuous changes and (3) accelerating individual commitment.Practical implicationsDuring crises such as pandemics, facilitation activities by IPC professionals need to embrace all the cognitive, behavioral and affective aspects to stimulate positive attitudes of frontline workers toward continuous and urgent changes.Originality/valueThis study provides unique and timely empirical evidence on the facilitation activities that support the implementation of evidence-based interventions by IPC professionals during crises in hospitals in a resource-poor country.

Highlights

Healthcare professionals call for novel approaches to assist in implementing evidence-based interventions in resource-poor countries (Yapa and B€arnighausen, 2018)
The facilitation activities performed by infection prevention and control (IPC) professionals during the COVID-19 pandemic are described in three overarching dimensions: (1) creating and sustaining legitimacy to continuous and rapid changes, (2) fostering capabilities for continuous change and (3) accelerating individual commitment
The findings show that the facilitation activities performed by IPC professionals during the COVID-19 pandemic focused on creating and sustaining legitimacy to continuous and rapid changes, fostering capabilities for continuous changes and accelerating individual commitment

Summary

Introduction

Healthcare professionals call for novel approaches to assist in implementing evidence-based interventions in resource-poor countries (Yapa and B€arnighausen, 2018). The difficulties stem from restrictions in responding to contextual barriers given the limited human, financial and structural resources (Costa et al, 2017). This is an enduring issue during crises such as pandemics, where conflicting guidelines, overwhelming information and limited resources hinder rapid implementation of evidence-based interventions (Rebmann, 2010; Moon et al, 2015). The study of implementation during crises is a relatively young field of investigation, and little is known about performing facilitation activities to promote the uptake of new and adapted evidence-based interventions introduced during crises such as pandemics

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