Facilitators and barriers to implementing new models of care for patients in a rehabilitation care setting: A systematic review.

IntroductionThis systematic review aimed to synthesize evidence on the key findings of evaluations of implementation of models of care in rehabilitation and describe facilitators and barriers to implementing new models of care.MethodSix electronic databases were searched. Abstracts and full texts were screened and critically appraised. Facilitators and barriers were classified using the Consolidated Framework for Implementation Research version 2.0.ResultsOf the 64 studies identified, 52 (81%) were new care models implemented in a hospital and 12 (19%) were situated in a home or community-based setting. Common implementation evaluation metrics reported included fidelity (n = 15), adherence (n = 16), feasibility (n = 14), and acceptability (n = 12). Facilitator domains were innovation source (e.g., uncomplicated models), outer setting (e.g., positive attitude), inner setting (e.g., teamwork or motivation), individuals (e.g., skill) and implementation (e.g., planning according to need and context). Barrier domains were innovation source (e.g., model complexity), outer setting (e.g. .organisational culture), inner setting (e.g., staff turnover, training, or resources,), individuals (e.g., no champions) and implementation (e.g., lack of planning).ConclusionsThe review highlights the importance of planning before implementing new models of care in rehabilitation settings to address potential facilitators and barriers in a real-world environment.