Implementing policy and practice changes in busy healthcare settings is not easy. Challenges are often due to factors particular to the clinic, broader organization, or larger healthcare system in which the clinic is based. The challenges may be magnified when the change is to improve services for communities facing stigma and discrimination.
A lot of things can get in the way of change. For example, employees may hold differing priorities when tailoring services to a subpopulation or lack relevant education and buy-in. Not having enough time or basic resources can also hamper efforts to introduce organizational changes to improve care for any patient group. In this section, we discuss implementation strategies. These strategies represent the “how-to” of making lasting changes at provider, clinic, organizational, and system levels. They are key to addressing the many “real-world” factors that can make it hard to implement new policies and practices.