Summary: implementation challenges and strategies for success
| Challenges | Strategies for success |
|---|---|
| Mandating attendance elicits negative attitudes in attendees | Offer classes as often as necessary, round the clock, evenings and weekends, off-site and on-site |
| Private physician engagement is challenging | Classes can be segmented and delivered over time at forums where these physicians may participate, such as Grand Rounds. Trainers also went to physician offices and delivered classes and materials, although this is not ideal in smaller practices, as it negates the interdisciplinary aspect |
| Trainer skillset is very important | Trainers must be accustomed to dealing with a variety of attitudes and behaviours without internalising; managers make excellent trainers. Our trainers have dealt with scepticism, scorn and hostility directed at themselves, heated discussion between participants and a variety of other passive-aggressive behaviours from their colleagues |
| Leadership engagement | In a multientity organisation, engage senior leadership first. Then engage site leadership according to implementation plan and senior leadership can assist if needed. Leadership participation in training and implementation is perceived very positively by staff. Leadership engagement in sustainment activities is also essential |
| Interdisciplinary classes are preferable | Staff practices in an interdisciplinary environment; so should they train. It is best to engage all the roles participating in a departments’ work together in training. For instance, on a general surgical unit, the daily team might include surgeons, surgical residents or fellows, physician assistants, nurse practitioners, nurses, pharmacists, nursing assistants, ward clerks, environmental/housekeeping staff, respiratory therapists, physical therapists, clergy, volunteers, etc. As much as possible, these roles should train together |