Targeted barriers | Theory-based KT strategy | Proposed mechanisms of action | KT activities |
---|---|---|---|
Lack of teamwork, trust, and communication | Interprofessional learning [66] and dialogue within a safe learning “container” [45] | Increased levels of interaction Strengthened relations Improved understandings between professionals groups and managers | Facilitating regular dialogue meetings between a selected group of professionals and managers (the Learning Lab group) |
Lack of knowledge regarding HAI, patient outcome and HH performance | Audit and feedback [60] Education based on adult learning theory [67], situated and experiential learning [68, 69] | Increased motivation and commitment Internal drive for seeking knowledge and change | Visualization of patient outcome data and behavioral feedback Mindful observations of one’s own and one’s peers’ HH practice Facilitated problem-based learning Co-creation of printed information material Reviewing “My five moments for hand hygiene” |
Skepticism about the value of HH and AT | “Celebrating” resistance Challenging basic assumptions [46] | Decreased skepticism about the evidence in support of HH and AT Increased commitment to change | Workshop welcome and encouraging participants’ diverse perspectives Facilitators actively seek to understand and address hesitation, questions and resistance in a respectful way Reviewing the evidence for HH and AT in relation to invasive procedures Co-producing printed evidence-based information on HH |
Lack of tailoring of the clinical guidelines to the OR context | Relevant and meaningful HH and AT routines | Step 1: Welcome and promote innovative new ideas; sense, probe, respond and reflect in an iterative process in the Learning Lab group Step 2: Involve OR staff in the testing, reflection and refining of standardized operational procedures | |
Lack of role models and opinion leaders | Role modeling from credible and trusted sources | Strive to create honest relationships between facilitators and participants Lab participant as change agents | |
Deficits in clinical leadership and change management skills | Facilitating development of clinical leadership skills [46] | Increased ability to understand and manage implementation in complex environments Increased awareness of the importance of leadership in change processes | Interactive mini-lectures on leadership, implementation and change management |