Supporting practice facilitators in a learning health care system [commentary].

The learning health care system (LHS) envisions the integration of research and care delivery in a manner that rapidly generates and adopts new evidence to improve health care quality and patient experience. Efforts to operationalize and evaluate the LHS have identified facilitation as a core construct when describing the implementation support needed to achieve the desired outcomes. There is a rich literature documenting the effectiveness of facilitation as a strategy for implementing evidence-based innovations that improve the quality of health care. Facilitation is enabled by practice facilitators (PFs) who activate implementation of changes that improve care quality. They help others navigate complex change processes when implementing new evidence into practice by assessing and responding to unique characteristics of both the interventions and the context within which they are being implemented. For the evaluation of LHSs, one proposed measure of the presence of adequate implementation support is a count of PF hours provided for care delivery initiatives. As a result, there is a growing interest in understanding how an LHS might prepare and support individuals to be effective in this role with the goal of improving care quality. This commentary piece examines five critical supports needed for a PF program within an LHD and offers suggested practical actions based on the authors’ experience that an LHS can take to enhance the effectiveness of facilitation as an implementation strategy to improve care quality and outcomes.