Background: Facilitation, a process of interactive problem solving and support, is often cited as an effective implementation strategy for health care settings. However, how and in what circumstances facilitation works in residential aged care specifically requires further investigation. There is a lack of understanding of the effects of specific implementation strategies used in residential aged care to enhance the uptake of evidence-informed palliative care.

Aims: To identify how and in what circumstances facilitation works for residential aged care staff in the implementation of interventions designed to improve palliative care.

Methods: Realist review methodology was selected to uncover the contexts and mechanisms that enable or hinder facilitation to develop transferable theories that could inform the implementation of future interventions. Guided by RAMESES standards a preliminary theory was generated, tested via literature extracted from Medline, PsycINFO, CINAHL and Google Scholar, and refined through synthesis. Two reviewers extracted, appraised and analysed the data.

Results: Middle-range theories in form of context-mechanism-outcome configurations have been developed and will be presented. This review finds that facilitators support the uptake of knowledge relating to evidence-informed palliative care through coherence building, realising absorptive capacity, building trust between stakeholders, and monitoring and iteratively adapting the implementation process to mitigate specific contextual barriers.

Conclusions: Realist synthesis is a useful method for further developing an understanding of how and in what circumstances implementation strategies work. The synthesised theories can be transferred and tested in practice to strengthen the uptake of research evidence in residential aged care.