Background: Health care-associated infections (HAIs) are among the major causes of death of hospitalized patients. The ability to find and solve problems relating to HAIs is heavily contingent on infection prevention and control (IPC) teams’ practices. Previous studies provide detailed insights into how IPC teams find appropriate solutions, but they do not addressed how problems are found. This limitation is a severe drawback as IPC teams may focus their attention on the wrong problems that leads to inefficient or suboptimal solutions.

Purpose: This study aims to understand how IPC teams find problems with HAIs from a Problem-Finding and Problem-Solving perspective.

Method: We performed a multiple case study of three hospitals located in Brazil and Sweden. We collected data from 3 exploratory interviews and 13 semi-structured interviews with nurses and physicians enrolled in IPC teams. Supplemented documents were used for data triangulation. Data were analyzed using a thematic approach.

Findings: Results from this study suggest an approach based on two different sets of activities for finding problems: practices for HAI prevention and for HAI control. Practices for HAI prevention comprises routinely and elective actions whereas practices for HAI control involve ad hoc and emergent actions. The practices are organized into problem-detection, -framing, and -formulation activities.

Conclusion: We identified and detailed practices that guide IPC teams’ attention to find valuable problems relating to HAIs. By detecting, framing and formulating problems, IPC teams can find appropriate solutions.

Practice Implications: A range of practices are detailed in our study to guide IPC teams’ attention in how to find relevant problems relating to HAI prevention and control as well as the criteria on how to prioritize latent problems to obtain needed solutions. Our study provides a basis for supporting decision makers on how to identify opportunities for improve IPC policies and practices.

Purpose: Facilitation activities support implementation of evidence-based interventions within healthcare organizations. Few studies have attempted to understand how facilitation activities are performed to promote the uptake of evidence-based interventions in hospitals from resource-poor countries during crises such as pandemics. This paper aims to explore facilitation activities by infection prevention and control (IPC) professionals in 16 hospitals from 9 states in Brazil during the COVID-19 pandemic.

Design/methodology/approach: Primary and secondary data were collected between March and December 2020. Semi-structured interviews were conducted with 21 IPC professionals in Brazilian hospitals during the COVID-19 pandemic. Public and internal documents were used for data triangulation. The data were analyzed through thematic analysis technique.

Findings: Building on the change response theory, this study explores the facilitation activities from the cognitive, behavioral and affective aspects. The facilitation activities are grouped in three overarching dimensions: (1) creating and sustaining legitimacy to continuous and rapid changes, (2) fostering capabilities for continuous changes and (3) accelerating individual commitment. Practical implications: During crises such as pandemics, facilitation activities by IPC professionals need to embrace all the cognitive, behavioral and affective aspects to stimulate positive attitudes of frontline workers toward continuous and urgent changes.

Originality/value: This study provides unique and timely empirical evidence on the facilitation activities that support the implementation of evidence-based interventions by IPC professionals during crises in hospitals in a resource-poor country.

© 2021, Luís Irgang, Magnus Holmén, Fábio Gama and Petra Svedberg