Table 4 Evidence to support CMOc1: the influence of learning collaboratives on the sustainability of a scaled, multi-component intervention

Case A-002: “So, every aspect of this intervention was collaborative and when I say that, the creation of it [the intervention] came from input and collaboration of operations, from units, to patients and families and to SCN staff. So, it was never done in silo of just a [name of SCN]. It was always done with an approach that there was representation from across the province.”

Case A-009: “We decided to use the innovative learning collaborative methodologies, which involved bringing together all 21 provincial teams, to be five learning sessions. And at these learning sessions, teams came together. We shared best practices. We shared guest presenters speaking about implementation. Speaking about clinical best practice for [name of intervention] and [name of work environment]. And teams had an opportunity to come together and network. They could work on…specific clinical best practices. There were four management metrics. And then they could choose two-unit specific metrics for which they chose best practices and clinical recommendations from the framework. And worked on implementing those through action plans of the learning collaboratives.”

Case B-005: “I think too another big piece was not having the intervention be just the responsibility of one person. So I think having, having the team actively engaged and involved and the team including families as well in that process. As we just talked earlier about the collaborative approach that you know, our medical director pitched in with the physicians. We had our program managers helping, coaching, mentoring the front line. You know our front-line nurses coaching and mentoring health care aides. So I think that was really key in that it wasn’t reliant on just one person to roll out the intervention that really, required a team effort and for everyone to be bought in. So I think that helped as well.”

Case B-010: “I really think it was the collaborative being an innovative collaborative. Having those three learning workshops. And the touch points in the middle, as opposed to having those one in done educations. Because you go to an education day, you get all hyped up, “oh my God! This is great information! We’re so excited!” And then you go back to your site and you are excited, but not all the other staff went to that education. And they have no idea what you are talking about. And then it is hard to implement something. Whereas when we do our collaboratives, we take a whole team. They come together and they make a plan on how to make change.”