Background
There are limited descriptions of implementation team processes supporting the success of evidence-based change efforts. Much of the literature focus is on practice, knowledge, and education delivery when implementing a new program. Information on team processes that contribute to advancing an idea or vision to a sustainable running program is lacking. The collaborative framework developed by Wine et. al describe dynamic processes and enabling conditions as the essential components that can hinder or progress productivity, performance, and knowledge translation. In this presentation, we explore this framework applicability to inform deeper understanding of the elements that contribute to successful implementation in the context of health care.

Methods
We are working across eight acute care sites in Western Canada to implement a rooming-in approach for parents and babies at risk of Neonatal Abstinence Syndrome. This approach is considered a safe and effective model of care. We are exploring the change processes within the unique contexts of acute care sites implementing this evidence-based model of care. Lessons learned from sites with an existing program inform implementation at other sites. Through a qualitative case study, we explored the conditions that supported the successful implementation of one mature program. We used the collaborative framework to inform data collection through focus groups, interviews, and surveys, and analysis procedures. We conducted both inductive and deductive processes using thematic analysis.

Findings
The underlying concepts of the collaborative framework helped shed light on the crucial role of team processes in the establishment and sustainability of the program. The dynamic processes and enabling conditions were contextually driven. At the heart of implementation was a dedicated, committed, and passionate core team with strong relationships across stakeholders. Growth of the program involved dynamic processes such as the building of relationships across sectors and extending the team involved in change. Processes focused on advancing individual and joint capacity building, through engagement in co-learning with staff and administration, expanding individual knowledge and shifts in attitudes to reduce bias and stigma to provide hopeful and evidence-informed care. It was pivotal for implementation to establish trust between families and staff, expand partnerships with parents and community supports, and develop joint responsibility with those involved and those most impacted by the program. Observing success was crucial for establishing buy-in and progression in this context. Additionally, the core team led change through constantly supporting staff and families, being attentive to stakeholders’ needs and engaging in inclusive reflective practices.

Conclusions
The collaborative framework was a useful tool providing a team science lens that contributes to deep understanding of team processes and effective collaborations in the context of implementation science. The framework facilitated highlighting team dynamics aspects, that often do not get attention, and provided focal areas to guide implementation efforts in the health care context.