Barriers and Facilitators to Implementing Homelike Models in Long-Term Care: A Scoping Review Using the Updated Consolidated Framework for Implementation Research

Background Home-like models in long-term care (LTC) aim to improve residents’ well-being, autonomy, and daily life experience. However, its implementation is inconsistent with variation in adoption and sustainability across settings. Objective To systematically identify and explain the multilevel barriers and facilitators that shape implementation of home-like models in LTC. Methods A scoping review of 36 peer-reviewed studies and 13 Canadian grey literature documents was conducted. Implementation factors were extracted and mapped to the updated Consolidated Framework for Implementation Research (CFIR 2022). Results Fifty-two implementation factors emerged (23 barriers, 29 facilitators). Inner Setting, including staffing instability, organizational culture, leadership, and resource availability, was the most influential but constrained by Outer Setting determinants (regulatory rigidity and funding). Among facilitators, adaptive leadership and staff engagement were most consistently identified, followed by supportive organizational culture and flexible regulatory approaches. Homes employing incremental or pilot-based strategies manage implementation complexity and sustain culture change over time.