title: Going beyond the identification of change facilitators to effectively implement a new model of services: lessons learned from a case example in paediatric rehabilitation.
abstract: OBJECTIVE
  To identify facilitators and barriers to service reorganization, how they evolved and interacted to influence change during the implementation of a new service delivery model of paediatric rehabilitation.
  
  
  METHODS
  Over 3 years, different stakeholders responded to SWOT questionnaires (n = 139) and participated in focus groups (n = 19) and telephone interviews (n = 13). A framework based on socio constructivist theories made sense of the data.
  
  
  RESULTS
  Facilitators related to the programme's structure (e.g. funding), the actors (e.g. willingness to test the new service model) and the change management process (e.g. participative approach). Some initial facilitators became barriers (e.g. leadership lacked at the end), while other barriers emerged (e.g. lack of tools). Understanding factor interactions requires examining the multiple actors' intentions, actions and consequences and their relations with structural elements.
  
  
  CONCLUSIONS
  Analysing facilitators and barriers helped better understand the change processes, but this must be followed by concrete actions to successfully implement new paediatric rehabilitation models.
authors: École de Réadaptation, Université de Montréal, Québec, Canada. chantal.camden@gmail.com
authors: Chantal
authors: C
authors: Camden
authors: Bonnie
authors: B
authors: Swaine
authors: Sylvie
authors: S
authors: Tétreault
authors: Monique
authors: M
authors: Carrière
mesh_terms: D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D009936:Organizational Innovation; D013222:State Medicine / Q000458:organization & administration*