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Table 4 Barriers and facilitators mentioned in focus groups

From: Barriers to implementation of a redesign of information transfer and feedback in acute care: results from a multiple case study

Acute care chain Barrier Facilitator
Implementation care chain (acute abdominal complaints) Routines Routines
  - Work routines differ between organizations involved in the care chain
  - Feedback is not provided formally yet
  - Providing feedback is not a work routine
  - A non-electronic form differs from current routines, as electronic systems are used
  - Procedures of information transfer and feedback are absent
Organization Organization
  - There is no coordination of the acute care chain   - The redesign should fit into the organization’s policy
Sense of urgency Sense of urgency
  - In practice, the sense of urgency might have been very low   - On a higher organizational level, there was a sense of urgency for improvement
Implementation methods  
  - Top down implementation approach
  - Implementation during holiday season
  - Features of the redesign itself
Other factors Other factors
  - Practical experience shows that care providers were not willing to work according to the redesign   - The redesign is desirable
Control care chains* (acute hip traumas, acute psychiatric care, CVA) Routines Routines
  - Work routines differ between districts and organizations involved in the care chain  
  - The redesign differs from the current work routines
  - Organizations are used to work with digital systems instead of paperwork.
Organization Organization
  - There is no coordination of the acute care chain   - The redesign should fit into the organization’s policy
Sense of urgency Sense of urgency
  - A need for improvement in information transfer and feedback is experienced, although may not be very urgent  
Implementation methods  
  - Top down implementation approach
  - Implementation during holiday season
  - Features of the redesign itself
Other factors Other factors
  - Willingness to work with the redesign depends on whether it is digital or not. As a paper version, willingness would not be very high   - The ideas behind the redesign are probably desirable
  1. *Acute care chains for Obstetrics and myocardial infarction are missing here since no FG interview was held with those care chains.
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