چکیده (انگلیسی):

Background:Practice facilitation has proven to be effective at improving care delivery. Practice facilitators are
healthcare professionals who work with and support other healthcare providers. To the best of our knowledge, very
few studies have explored the perspective of facilitators. The objective of this study was to gain insight into the
barriers that facilitators face during the facilitation process and to identify approaches used to overcome these
barriers to help practices move towards positive change.
Methods:We conducted semi-structured interviews with four practice facilitators who worked with 84 primary
care practices in Eastern Ontario, Canada over a period of five years (2007–2012). The transcripts were analyzed
independently by three members of the research team using an open coding technique. A qualitative data analysis
using immersion/crystallization technique was applied to interpret the interview transcripts.
Results:Common barriers identified by the facilitators included accessibility to the practice (e.g., difficulty scheduling
meetings, short meetings), organizational behaviour (team organization, team conflicts, etc.), challenges with practice
engagement (e.g., lack of interest, lack of trust), resistance to change, and competing priorities. To help practices move
towards positive change the facilitators had to tailor their approach, integrate themselves, be persistent with practices,
and exhibit flexibility.
Conclusions:The consensus on redesigning and transforming primary care in North America and around the world is
rapidly growing. Practice facilitation has been pivotal in materializing the transformation in the way primary care
practices deliver care. This study provides an exclusive insight into facilitator approaches which will assist the design
and implementation of small- and large-scale facilitation interventions.