Data-Driven Approach for Tailoring Facilitation Strategies to Overcome Implementation Barriers in Community Pharmacy

Abstract Background: Implementation research has delved into barriers to implementing change and interventions for the implementation of innovation in practice. There remains a gap, however, that fails to connect implementation barriers to the most effective strategies and provide more tailored interventions during implementation. This study aimed to link implementation barriers to facilitation strategies during a study in community pharmacy and use a data-driven approach to predict the level of effectiveness of facilitation strategies to overcome these barriers.Methods: Six Change facilitators facilitated a two-year change program aimed at implementing professional services across 19 community pharmacies across Australia. A mixed method approach was used where barriers were identified and coded according to implementation factors from the Consolidated Framework of Implementation Research, the Theoretical Domains Framework and the Integrated Checklist of Determinants of practice. Change facilitators trialled and recorded different facilitation strategies to overcome these barriers, until the barrier was resolved. To predict the effectiveness of these strategies a data mining approach named Random Forest was used to provide the highest level of accuracy. Results: At the end of the program, 1,131 data points were recorded by change facilitators. Upon analysis, 36 barriers were identified. The most frequently identified barrier was a ‘lack of ability to plan for change’ (n=184). A list of 111 change facilitation strategies were extracted from the data. These were coded into 16 facilitation categories according to the Taxonomy of Facilitation Strategies. The most effective strategy category to overcome an ‘inability to plan for change’ was to ‘engage stakeholders by creating ownership’ which had a Predictive Resolution Percentage of 84%. Conclusions: Results from this study have provided a better understanding of implementation barriers in community pharmacy and a data-driven approach to predict the effectiveness of facilitation strategies to overcome these barriers. Tailored facilitation strategies may increase the rate of implementation of innovations in healthcare, leading to an industry that can confidently adapt to continuous change.