← Implementation Enablers — Implementation Teams
The development of an implementation team is a key step for successful implementation.
Implementation requires dedicated people who can provide direction and support. The development of an implementation team is a key step for successful implementation.
Implementation teams oversee, support and attend to implementation. They lead change and provide guidance to others who will be impacted by it (Hirsch, 2017). They are accountable for change and progress, and can also hold others to account. They should not be confused with other groups or structures such as governance groups or steering committees. They are different in that they are actively involved in overseeing and managing the implementation process. They typically have some decision-making authority but rely on other governance structures for major decisions.
What implementation teams do
- Moving an innovation through the stages of implementation
- Identifying barriers and finding solutions where needed
- Identifying enablers and leveraging them for successful implementation
- Securing resources to support implementation
- Putting in place infrastructure to support implementation
- Engaging stakeholders and communities
- Building cross-sector collaboration and alignment between relevant agencies
- Monitoring and evaluating progress
- Using data to make decisions and support implementation
- Ensuring decisions are purposeful and planned
- Ensuring that the innovation is being implemented as intended (fidelity).
Skills and competencies needed by implementation teams
Implementation teams need a range of skills and competencies to oversee, support and attend to the implementation of interventions. Teams need a mix of skills, including content knowledge and expertise developing teams, implementation, improvement cycles and systems change.
External expertise may be needed to support implementation teams, to complement existing skills and competencies. There is increasing interest in the field of implementation science about what is needed to facilitate change in complex systems. ‘Implementation Specialists’ can provide skills and competencies to support large scale interventions.
Putting together an implementation team
Implementation teams are typically made up of 3-12 people. The composition of this group is important, and should address the following needs:
- Diversity – does the team have an appropriate balance of perspectives, training and expertise, experience, relationships and priorities?
- Decision-making authority – the team should include members who have decision-making authority or have direct access to decision-making authority, so that timely decisions can be made
- Knowledge – the team should include members who have a range of relevant skills and expertise.
Documents which set out the position, expertise and rationale for including members can help to ensure that a team has the right balance of diversity, authority and knowledge.
It may be possible to repurpose an existing team to work on implementation, but the team needs to reflect these needs. Additional members may need to be recruited to address any imbalance.
Teams can be established at local, regional or national levels and should be linked. One implementation team may not be enough to implement an initiative at national level. Additional teams may be required, but will need to be linked, with two way communication between them. Linked implementation teams can help to drive change and ensure a coherent and consistent approach.
Implementation teams in action
The Health Services Executive (HSE) Nurture Programme – Infant Health and Wellbeing, aims to improve the health and wellbeing for infants under the age of two and their parents. The HSE has established six national implementation teams. Each team has specific roles and responsibilities and communication protocols for communicating between teams and governance structures.
A wide range of stakeholders are represented on the teams, including representatives from public health nursing, public health medicine, practice nursing, midwifery, speech and language therapy, health promotion, training and development, ICT, academia, administration, and community and voluntary organisations. A full-time programme manager sits on each of the teams. Project support and implementation support is also provided to each team.
Implementation plans guide the work of the teams, which are monitored and updated over time. Whilst the team do not have control over budgets, they regularly inform budgetary decisions made by governance structures.
Tips for effective implementation teams
- Appoint a chair that is skilled in group facilitation and has credibility and respect from a broad range of stakeholders. They do not necessarily need to be an expert in the subject matter.
- Try to keep the size of the team manageable (i.e. less than 12), but ensure that the range of perspectives needed are included.
- Clarify the role, scope and mandate of the team in the Terms of Reference, and in how the team relates to any other teams and structures.
- Develop an implementation plan for the team and monitor progress and update it on an ongoing basis.
- Create sub-groups for specific tasks that cannot be completed within the teams. Consider including other stakeholders, who are not part of the team, but who have specific expertise that would be helpful.
- Use evidence to inform decisions made. If evidence is not available, collect it through, literature reviews, surveys, focus groups and interviews.