This is coming along nicely.
There is a class on organizational sociology that will provide a lot of insights here.
One possibility is to approach the "high performing" facilities with a blank slate and see what you can learn.
A little advanced thinking about things like organizational culture, leadership and managerial processes at these units might position you well to dive into the qualitative data.
There is for example an instrument of management capability developed by someone at Stanford Business School. I'll have to dig this up - let me know if you are interested in it.
Another random scale for ability to take up evidence (maybe this one applies more after the recent JAMA paper by your colleagues) that may or may not fit your context.
- Aarons, Gregory A. "Mental health provider attitudes toward adoption of evidence-based practice: The Evidence-Based Practice Attitude Scale (EBPAS)." Mental health services research 6.2 (2004): 61-74.